Head injury causes, symptoms, treatment and prevention methods

Head trauma is a common injury.

You can get it anywhere: at home, on the street, in the gym.

It doesn’t matter if a person slipped during icy conditions, missed a punch in a fight, or lost his balance and straightened the corners of furniture.

Injury resulting from a blow to the head is extremely dangerous.

Damage to the parietal region can result in a concussion or fracture of the skull bones. A bruise of the temporal part ends in fainting.

Types of traumatic brain injuries

Injuries caused by a head impact are called TBI for short. There are several types of damage.

Concussion (CHM)

With a strong impact on a hard surface, the gray matter is displaced and after a second returns to its original position. This is how a double displacement of the brain occurs.

FMS is reported equally often in adults and children. This is the most common head injury. It accounts for 70% of all registered TBIs. Symptoms that may indicate a concussion:

• feeling of weakness;
• short-term (up to 15 minutes) loss of consciousness;
• vomiting, feeling of nausea;
• headache;
• inability to remember how the injury occurred;
• dizziness;
• respiratory dysfunction;
• blurred vision;
• Pain in the eyes.

SMG can happen even after a blow to the jaw. Then pain when chewing and talking is added to the symptoms.

Body temperature and blood pressure are restored in a short time after injury. But unpleasant consequences in the form of nausea and dizziness make themselves felt for a long time. The matter is aggravated by problems with falling asleep, up to complete insomnia.

If there is a suspicion of a concussion, a doctor's examination is required. If the symptoms of injury are minor, the patient is allowed treatment at home. It is allowed to use folk remedies, such as head massage and a special linen patch. In some cases, hospital treatment is recommended.

Brain compression

The main risk is damage to the stem formations in the cerebellum area. This area of ​​the brain is responsible for breathing and regulates blood circulation.

Therefore, it is extremely important to examine the patient and conduct an MRI. If the presence of internal hematomas is determined, they are urgently removed. Hemorrhages increase pressure on the brain and aggravate the patient’s condition.

Brain contusion

A common injury among boxers. It also develops after a beating, a fight, or a strong blow to the head. As a result:

• cranial vault injury;
• damage to brain tissue;
• necrosis of affected areas.

The presence of a brain contusion can be judged by the following signs:

• loss of consciousness (always);
• disorientation in space;
• feeling dazed;
• memory impairment;
• cephalgia;
• bouts of vomiting;
• disruptions in heart function and breathing;
• neurological symptoms (Kernig's syndrome, nystagmus);
• throbbing pain in the occipital region.

If the injury results in a fracture of the skull bones, it may look like a dent in the back of the head. Remember, if there are fragments that get into the brain matter, life support functions will be affected. Roughly speaking, a person can die or go into a vegetative state.

There are three degrees of severity for brain contusion. A mild degree occurs in children. High activity combined with carelessness leads to damage. Moderate and severe damage most often occurs in adulthood. More often these are fights and traffic accidents.

As therapy, neurologists prescribe:

• neuroprotectors;
• antioxidants;
• drugs that strengthen blood vessels.

Axonal damage

Severe injury causing contusion. After this, brain activity stops. The man falls into a coma. The injury is not treated, but only supported by the vital functions of the body. Making predictions regarding recovery is extremely difficult. The individual characteristics of the organism play a decisive role.

How is a noise in the head diagnosed after a head impact?

If there is a history of recent TBI, then this is the main possible cause of noise in the head. The doctor conducts a physical examination, studies the patient’s complaints, conducts neurological testing: checks reflexes, identifies motor and speech disorders.

With mild concussions and bruises, patients often do not seek medical help, which is why the consequences of TBI are delayed.

The doctor must prescribe an additional instrumental examination, which includes the following diagnostic methods:

• Radiography. Shows the integrity of the skull bones. It is performed in two projections: direct and lateral.
• Computed tomography (CT). Informative regarding skull fractures, brain contusions, hematomas.
• Magnetic resonance imaging (MRI). Allows you to identify swelling of soft tissues, areas of hemorrhage, structural changes, and determine the dislocation of the cerebral hemispheres. It is carried out to diagnose post-traumatic complications, which include frequent headaches and noise in the head, and is the most informative method. You can get an MRI at the SmartMed clinic, where a new MRI scanner is installed. The examination has a high degree of accuracy, so you can reliably determine the cause of noise in the head.
• Angiography of cerebral vessels. Allows you to identify all vascular disorders that can cause noise and headaches.
• Encephalography. Designed to assess the functional activity of the brain in order to identify functional disorders that arose after TBI.

Based on the examination results, the doctor determines the cause of the headache and ringing.

Since the appearance of these symptoms may be associated not only with damage to blood vessels or nervous tissue, increased intracranial pressure, but also with stress and a depressive state after a TBI, you should visit a psychologist or psychotherapist.

Classification of TBI by severity

There is a special Glasgow scale. It helps determine the severity of the head injury. Experts conduct tests and evaluate:

• motor reactions;
• speech reactions;
• opening the eyes.

For each test, points are awarded and summed up:

• 14-16 - mild degree;
• 9-13 - average;
• 8 - heavy;
• 3 or less - deep coma.

Regardless of the severity of the injury, it is important to seek help promptly. Timely and adequate therapy reduces the risk of complications and improves the prognosis.

Glasgow Coma Scale (GCS)

When assessing the severity of a patient’s brain injury, specialists take into account the level of neurological deficit (loss of function) and the level of clarity of consciousness. For ease of assessment in clinical practice, all these indicators (focal neurological symptoms, level of consciousness) were compiled into a Glasgow Coma Scale (GCS) by neurosurgeons from the University of Glasgow in 1974 (Professors Graham Teasdale and Bryan J. Jennett).

Glasgow Coma Scale (GCS) for traumatic brain injury:

Note: Coma points = D + R + G. Patients scoring 3 or 4 on the Glasgow Coma Scale have an 85% chance of dying or entering a residual vegetative state. Patients who score more than 11 on the Glasgow Coma Scale have only a 5–10% chance of death or a residual vegetative state and an 85% chance of moderate disability or full recovery. Mean Glasgow Coma Scale scores correlate with the proportional odds of recovery.

The classification of traumatic brain injury is based on many factors. An alternative traumatic brain injury severity scale.

Peculiarities of manifestation of traumatic brain injuries in children

In babies under one year of age, there is a sharp increase in temperature to 38°C and above. This reaction is associated with:

• wound infection;
• inflammation;
• suffered stress;
• inappropriate use of medications.

The child is not able to clearly describe his feelings, so it is quite difficult to make a diagnosis. There is a risk of underestimating the severity of the injury. Warning signs in this case are:

• pale skin;
• lethargy, drowsiness;
• increased heart rate.

Over time, vomiting, regurgitation, tearfulness, and capricious behavior appear. The baby sleeps restlessly and often gets up at night. If it is SHM, then the symptoms go away within a week.

Please note that infants and the elderly do not experience fainting during SHM.

First aid

After a head impact, signs of TBI appear quickly. The main thing is to be careful. The most striking symptoms: vomiting, nausea, fainting. It is very important not to get lost, to act confidently and quickly:

• Call the doctors.
• Apply something cold to your head (ice, compress). This will help narrow the blood vessels, minimize the risk of hematomas, hemorrhages, lumps, and prevent or reduce swelling.
• Carefully examine the victim. Sharp pain in the neck may indicate damage to the vertebrae. It is important to fix the position and not change it until the ambulance arrives.
• In case of fainting, bring ammonia to your nose. Wipe with cool water. It is strictly forbidden to hit people on the cheeks. Such an action will increase the consequences of damage.
• Treat wounds. The use of chlorhexidine and hydrogen peroxide is allowed.
• If heavy bleeding begins in the temple area (spouts like a fountain), pinch the vessel with your fingers. After this, apply a bandage with furatsilin or miramistin. After attaching the bandage with a bandage, wrap your head with a bandage.
• If vomiting occurs, place the person on their side. This is necessary for the random flow of vomit so that the victim does not choke. It is advisable to place a clean cloth and change it periodically when it gets dirty.

Having done everything necessary, you need to wait for the doctors. If a person has not lost consciousness and feels more or less normal, you can not call an ambulance, but take him to the hospital yourself. The main thing to remember is that the consequences of TBI can be quite serious. Only a doctor can assess the condition, so a visit to the clinic should not be neglected.

Signs of serious injury

Call a doctor immediately if you notice any of these symptoms:

• loss of consciousness;
• dizziness, pallor;
• lethargy, lethargy;
• bleeding from the wound for more than 10 minutes;
• bleeding from the ears or nose;
• convulsions or sudden erratic movements;
• nausea, vomiting, and for infants - frequent regurgitation;
• blood in stool, urine, vomit;
• different pupil widths;
• hearing or vision impairment;
• restless sleep.

Before the ambulance arrives, place the baby on his side to allow vomit to escape unhindered and secure him in a safe position. Check your pulse, evenness of breathing, and pupil size. Medicines should not be given, as this may complicate the examination of the child and blur the symptoms.

Treatment

For severe TBIs, surgery is usually performed. The procedure may consist of primary surgical treatment. But sometimes, you have to do craniotomy, pump out fluid, remove hematomas, restore (assemble) the skull. After surgery, it is treated with medications.

If the victim is vomiting, it is stopped with an injection of Metoclopramide or Etamzilate. Pain is relieved with analgin. If there is no vomiting, they give a tablet (no more than 2 per dose), otherwise it is administered by injection.

In order to normalize blood circulation and metabolic processes in the brain, Etamzilat and Piracetam are prescribed. The standard dose is 2 tablets (varies depending on the patient’s age).

In addition, based on the nature of the injury and its clinical manifestations, he may prescribe:

Even if the patient is at home, it is important to follow the following recommendations:

• avoid sudden movements;
• stay in the shade, do not overheat;
• ensure silence;
• get plenty of rest and sleep.

Treatment of noise in the head after injury

If the noise in your head does not go away after the injury is healed, something needs to be done. Complex therapy will be required. Treatment methods:

• Taking medications. The doctor chooses medications taking into account the existing problems. These can be anti-inflammatory non-steroidal drugs, analgesics, nootropics, drugs that normalize the tone of blood vessels and improve blood circulation, neuroprotectors. For cervical muscle spasms, muscle relaxants are prescribed, and vitamin and mineral complexes are prescribed to maintain good health.
• Physiotherapeutic procedures. Electrophoresis, electrical stimulation, magnetic therapy, ultrasound therapy and others are used.
• Head and neck massage. It can be done only after the end of the acute period, if there are no contraindications, which include high blood pressure, inflammatory and oncological processes, vascular thrombosis, etc.

The severity of the consequences, and, consequently, the duration of treatment depends on the degree of damage to the brain structures. Chronic headaches and noise in the head will take a long time to be treated. In general, full recovery after a TBI takes about 1.5-2 years, but symptoms disappear within a few months.

If after a traumatic brain injury the headache does not go away within 3 months, treatment is required

To increase the effectiveness of therapy, the following doctor’s recommendations should be followed:

• stop drinking strong tea and coffee, alcoholic beverages, and smoking;
• get enough sleep, sleep at least 8 hours at night, fall asleep before 22:00;
• switch to easier physical and mental work;
• stop watching TV or computer;
• walk in the fresh air more often;
• avoid stress, noisy and crowded places;
• switch to proper nutrition, do not eat fatty and fried foods.

After a concussion and other head injuries, the patient is less able to tolerate changes in weather conditions, any stress, his memory deteriorates, and diligent mental activity is accompanied by headache and dizziness. Mood and blood pressure swings are not uncommon.

How a person will feel after hitting their head depends on the timeliness and correctness of medical care.

Diagnosis of TBI

Even if you provided first aid, know how to treat, and have previously encountered similar injuries, do not be arrogant. Examination of the victim by a qualified physician is mandatory. If you don’t want to call an ambulance, take him to the clinic yourself. Just before doing this, make sure that the spine is damaged and the skull bones are not cracked.

The most accurate conclusion can be made using magnetic resonance therapy and computed tomography of the head. The procedures are painless. With their help, you can thoroughly study the structure of the brain, look for the presence of hemorrhages, hematomas, etc.

If it is not possible to do MRI and CT (the clinic does not have machines), diagnostics should include:

• X-ray of the skull.
• Encephalography of the head.
• Examination by an ophthalmologist.

Encephalography will also help detect hemorrhage. In this case, hospitalization cannot be avoided.

If, after an injury, the patient has liquor leaking from the ears or bruises under the eyes in the form of glasses, you should consult a doctor immediately. Self-medication or lack of help, in this case, often leads to death.

You can undergo an MRI or CT scan in Moscow at any time of the day and regardless of the day of the week. You can find a clinic with 24-hour service, close to the patient, using the service: https://msk-mrt.ru/articles/. There are hundreds of medical centers operating in different modes here. Within a few minutes you can find a clinic and make an appointment by phone. Registration through the website allows you to get a discount on the examination.

First aid for head injury

It must be remembered that any head injury can be dangerous, so after providing first aid you should consult a doctor. Immediately after a bruise, it is advisable to take a horizontal position.

If the victim loses consciousness (even for a short period), dizziness, vomiting without nausea, confusion or vision problems, you must immediately call an ambulance.

Light superficial injuries (abrasions, cuts) do not require special treatment; primary treatment is sufficient. If the skin is damaged, an antiseptic must be applied to the wound: Hydrogen peroxide, Chlorhexidine, Miramistin.

In some cases, a bandage is applied to the affected area. If the wound is too deep and bleeds heavily, stitches may be necessary. Subcutaneous tense hematomas are opened under local anesthesia.

Indications for hospitalization

A doctor may refer you for hospitalization if there are the following grounds:

• post-traumatic amnesia;
• prolonged loss of consciousness;
• coma;
• epileptic seizure;
• bleeding;
• disorientation;
• obvious disorders of the nervous system;
• the patient is pregnant (even if she feels normal).

During treatment for TBI, the patient's condition may fluctuate. Periodically, the symptoms intensify and subside. Predictions can only be made after a full course of therapy. Unfortunately, the mortality rate for TBI reaches 25%. The main cause of death is inadequate first aid and reluctance to go to the hospital.

Definition

A head injury occurs when a person falls or hits the skull with a hard object; the condition can be life-threatening and requires immediate treatment.

Even weak blows to the skull area lead to an increase in the permeability of the blood-brain barrier, the development of autoimmune reactions in the tissues of the central nervous system, and neurodegenerative changes.

If you hit the back of the head, forehead, or temple hard, the tissues of the brain and skull will be damaged, which can be hidden from view during a visual inspection when there are no violations of the integrity of the skin. A fracture of the bone structures of the skull is a life-threatening disorder, which is always accompanied by a change in the morphological structure of the brain matter.

A dent on the forehead, crown or back of the head after a blow is a reason to suspect a fracture of the cranial bones. Other signs to look out for include softening of the bone structures of the skull, progressive loss of motor coordination and other reactions. If you shake your head, it is important not to make sudden movements, which can aggravate the dysfunction of the brain.

If struck, a person may be seriously injured. As a result of a skull fracture, pneumocephalus (air entering the cranial cavity) often develops. A common complication of head injury is damage to the cranial nerves. The condition is accompanied by paresis of the facial muscles and visual impairment.

Often the pathology is combined with damage to the spinal column in the cervical region. Airway obstruction (obstruction) is a common cause of early death in TBI. Head injuries in 90% of cases are accompanied by loss of consciousness, which correlates with a decrease in the tone of the muscles located in the pharynx. A decrease in tone leads to a displacement of the tongue and soft palate, which causes a violation of the patency of the respiratory system.