A concussion is a form of closed traumatic brain injury. As a rule, this is an easily reversible dysfunction of the brain, resulting from a bruise, blow, or sudden movement of the head. It is believed that due to a concussion, there is a temporary disruption of interneuronal connections.
As a result of contact of the substance of the brain with the bones of the skull, as a rule, occurs:
- a change in some of the physical or chemical properties of neurons (brain cells), which can change the spatial organization of protein molecules;
- the entire substance of the brain is susceptible to pathological effects;
- temporary disconnection of relationships and signal transmission between synapses (a synapse is the place of contact between two neurons or between a neuron and an effector cell receiving a signal) of neurons in cells and brain regions. This contributes to the development of functional disorders.
Depending on the severity of the patient’s condition and clinical symptoms, there are three degrees of concussion:
- Mild concussion. There is no impairment of consciousness, the patient may experience disorientation, headache, dizziness, nausea during the first 20 minutes after the injury. After that, the general state of health returns to normal. A short-term increase in temperature is possible (37.1-38 ° C);
- Concussion of moderate severity. There is no loss of consciousness, but there are pathological symptoms such as headache, nausea, dizziness, disorientation. They all last more than twenty minutes. Possible short-term memory loss (amnesia), most often retrograde amnesia with the loss of a few minutes of memories prior to brain injury;
- Severe concussion. It is necessarily accompanied by loss of consciousness for a short period of time, usually from several minutes to several hours. The patient does not remember what happened – retrograde amnesia develops. Pathological symptoms disturb a person for one to two weeks after injury (headache, dizziness, nausea, fatigue, disorientation, impaired appetite, and sleep).
The first thing to remember is that even a mild head injury can lead to a concussion. Consequently, the fact of the presence of an injury may already indicate a possible concussion.
Symptoms of a concussion include:
- short-term confusion of consciousness;
- dizziness. It is observed at rest, and with a change in the position of the body, turning or tilting the head, it increases. Its cause is a violation of blood circulation in the vestibular apparatus;
- headache of a throbbing character;
- noise in ears;
- nausea, single vomiting;
- lethargy delayed incoherent speech;
- diplopia (double vision). When trying to read, pain is felt with eye movement;
- photophobia. The eyes can react painfully to normal light levels;
- hypersensitivity to noise, even mild sounds can be annoying;
- violation of coordination of movement.
Symptoms of a concussion in children
The main signs of a concussion are loss of consciousness for a short period of time, headache, dizziness, and weakness. In some cases, there may be poor eyesight. Symptoms of a concussion in a child depend on age. The clinical symptoms of this condition in infants are as follows:
- frequent regurgitation (single vomiting is possible);
- the pallor of the face;
- decreased appetite and refusal to eat;
- swelling of the fontanelle;
- bad sleep, moodiness, unreasonable crying.
Symptoms of a concussion in children between three and six years of age:
- possible short-term loss of consciousness;
- nausea and vomiting (single);
- the pallor of the skin;
How does a concussion manifest in adolescents:
- obvious loss of consciousness (10 to 15 minutes);
- strong headache;
- pronounced violation of the regime;
- persistent nausea and vomiting;
- the presence of neurological symptoms;
- the temperature in children remains normal.
Please note that a characteristic feature of concussion in childhood is an increase in symptoms. If immediately after the injury, the child’s condition can be characterized as quite satisfactory, then over time it deteriorates noticeably.
In case of a head injury, a specialist consultation is necessary! Timely diagnosis and treatment will help to avoid complications and serious consequences.
Diagnosis of a concussion
Diagnosis of a concussion is based on history, examination, and exclusion of more severe traumatic brain injury. With a concussion, loss of consciousness lasts no more than 15-30 minutes after the injury. Short-term retrograde amnesia is possible. Anterograde amnesia is not common with concussions. With a concussion, a number of non-specific symptoms are observed, the presence and severity of which varies individually.
Concussion symptoms bother the patient for 5-8 days after the injury and then regress. Longer persistence of symptoms indicates the development of post-contusion syndrome in the patient. If more severe forms of TBI are excluded, and the patient’s condition continues to deteriorate over time, then it is necessary to look for other causes of the existing symptoms – psychological problems, mental illness, side effects of drugs, or other concomitant diseases.
First aid for concussion
If the patient is unconscious, call an ambulance immediately. The unconscious person should be laid on a hard surface on the right, legs and elbows bent. Tilting your head up and facing the ground – this position will ensure good air passage through the respiratory tract and prevent aspiration (entry of foreign substances into the respiratory tract when inhaling) fluid during vomiting. If the patient is bleeding from a head wound, a hemostatic bandage should be applied. If the person regained consciousness or there was no fainting at all, lay him down horizontally with his head elevated; constantly monitor consciousness, do not let the patient fall asleep, and wait for an ambulance.
What to do after a concussion
The main thing in the treatment of concussion is adherence to bed rest, adequate sleep and rest, the absence of any physical and mental stress, especially in the first few days. If the patient followed all the medical recommendations and the treatment was started on time, the concussion almost always ends in full recovery and restoration of working capacity.
Some patients may still have long-term residual effects of trauma. Among them – decreased concentration of attention, irritability, increased fatigue, depressive disorders, memory impairments, persistent headaches, migraines, sleep disturbances. As a rule, after the first year, all these symptoms are alleviated, but there are times when they bother a person throughout his life.
Medication treatment is of a secondary nature, but nevertheless, it is prescribed to each patient for a speedy recovery, getting rid of pathological symptoms, the general strengthening of the body, and preventing possible complications. Usually, drugs improve cerebral circulation, reduce headaches, relieve dizziness and nausea. In parallel, drugs have neuroprotective properties and improve the course of various processes in the brain. They also use sedatives and sleeping pills. At the stage of rehabilitation, general tonic and nootropic drugs are prescribed.
For a month after the concussion, it is not recommended to do heavy physical work; it is necessary to limit sports. In no case you should break bed rest, it is recommended to give up watching TV, being at the computer, and reading books for a long time. It is better to listen to quiet music without using headphones. If you do not follow the doctor’s recommendations and ignore the treatment, health problems can arise after a concussion. Approximately 3% of patients have complications such as epilepsy, persistent asthenic syndrome, insomnia, migraines, and other conditions.