Brain injury is divided into closed, open and penetrating. Shock, contusions and brain compression are distinguished by types of injury.
A special form of contusions of the brain includes diffuse axonal brain injury – these are complete and/or partial common axonal ruptures in frequent combination with small-focal hemorrhages, caused by trauma of mainly inertial type. The lethality of diffuse axonal brain damage is very high and can reach 80-90%, and survivors often develop a vegetative state.
Consequences of craniocerebral traumas
Post-traumatic epilepsy develops more often in victims who had epileptic seizures in the early period of Cranial Trauma. It most often occurs with a depressed fracture accompanied by brain damage.
In 50% of the victims post-traumatic epilepsy develops within 1 year after the Cranial Brain Injury and in 70-80% – within 2 years.
- Traumatic asthenia is expressed in irritability and exhaustion. Patients become unrestrained, passionate, impatient, unyielding, grumpy. Easily come into conflict, then repent of what they have done. In addition, the patients are characterized by rapid fatigue, indecision, disbelief in their own strength and capabilities. Patients complain of distraction, forgetfulness, inability to concentrate, sleep disorders, as well as headaches, dizziness, increasing with “bad” weather, change of atmospheric pressure.
- Traumatic apathy is manifested in the combination of increased exhaustion with lethargy, retardation, decreased activity. Interests are limited to a narrow range of concerns about their own health and necessary conditions of existence. Memory is usually broken.
- Depression is accompanied by tearfulness or gloomy angry mood.
- Traumatic dementia occurs in about 5% of people who have suffered a brain injury. It is more often observed as a consequence of severe open craniocerebral injuries with lesions of frontal and temporal lobes. The development of dementia is facilitated by repeated traumas, frequent psychosis, joined vascular lesions of the brain, alcohol abuse. The main signs of dementia are memory disturbances, decreased interests and activity, disinhibition of attractions, lack of critical assessment of one’s own state, annoyance and misunderstanding of the situation, revaluation of one’s own abilities.
The diagnosis “brain concussion” is made based on anamnesis. Usually, a victim reports that a head concussion occurred, which was accompanied by short-term loss of consciousness and single vomiting. Severity of the earthquake is determined by the duration of loss of consciousness – from 1 minute to 20 minutes. At the moment of examination the patient is in a clear condition, may complain about headache. No deviations, except for pale skin, are usually not detected. In rare cases, the victim can not remember the events preceding the injury. If there was no loss of consciousness, the diagnosis is made as doubtful. Within two weeks after concussion, weakness, increased fatigue, sweating, irritability, sleep disturbance may be observed. If these symptoms do not disappear for a long time, then it is worth reconsidering the diagnosis.
Manifestations of craniocerebral injuries
If the brain contusions are mild and the victim may lose consciousness for an hour, and then – complain of headache, nausea, vomiting. There is a twitching of the eyes when looking to the side, asymmetry of reflexes. X-ray may show a fracture of the bones of the vault of the skull, in the liquor – an admixture of blood.
Contusion of the brain of medium severity is accompanied by loss of consciousness for several hours, the patient does not remember the events preceding the trauma, the trauma itself and what happened after it, complains of headache and repeated vomiting. The following may be noted: blood pressure and pulse disorders, fever, chills, muscle and joint soreness, seizures, visual impairment, irregular pupils, speech disorders. Instrumental studies show fractures of the vault or base of the skull, subarachnoid hemorrhage.
In case of a severe contusion of the brain, the victim may lose consciousness for 1-2 weeks. In this case, he has gross violations of vital functions (heart rate, pressure level, breathing frequency and rhythm, temperature). The movements of the eyeballs are coordinated, muscle tone is changed, swallowing is disturbed, weakness in the hands and legs can reach a seizure or paralysis. Typically, this condition – a consequence of fractures of the vault and base of the skull and intracranial hemorrhage.