Closed craniocerebral injury occurs from blunt objects and is characterized by symptoms of brain damage with the presence or absence of violations of the integrity of the bones of the skull. While the skin of the head still intact.
There are three main forms a closed craniocerebral injury - concussion, injury and compression of the brain.
Concussion (commotio cerebri) - closed mechanical damage to the brain with the development of a specific symptom of violations of its functions without a clear focal depositions, develops more often in trauma occipital, frontal areas.
On the severity of the clinical picture concussion divided into three stages - easy, medium and hard.
Mild concussion slight disorders of brain function, smooth course and a favorable outcome. Loss of consciousness immediately after the injury lasts for 1-2 minutes Patients independently rise, experiencing a slight dizziness, nausea, sometimes vomiting. In further developing headache that lasts 5-7 days. After treatment within 7 -10 days of patients discharged from hospital.
When a brain concussion of medium severity of the patient loses consciousness for up to 1-2 hours. There is no response from the surrounding, the muscles are relaxed, breathing shallow, the face covered with sweat. Even after returning consciousness patients lie still, due to the General weakness, not interested in the incident with them. The circumstances of the injury't remember (retrograde amnesia). Sometimes patients are developing phenomenon of anxiety, agitation. 4-5 days the casualty's condition improves. Write a patient from a hospital, usually on the 20th day.
When severe concussion immediately after the injury develops deep loss of consciousness, which may last several days. Patients lie with his eyes closed in a kind of "spread" position because of the General muscular hypotonia. There is absolutely no response to external stimulation. Reflex activity is suppressed. Changed the function of respiratory and cardiac function. Consciousness is recovering slowly over several weeks. Upon returning consciousness patients do not remember what happened to them. Long remain headaches, dizziness, nausea and vomiting. Sometimes patients die in the first day after injury due to increased intracranial pressure, hyperthermia, a violation of the functions of the cardiovascular system and respiratory system. Therefore, when severe concussion patients require constant and close attention from on-duty medical personnel (see patient Care, the care of neurological patients). Under favorable course you must stay in bed until 4 or 5 weeks, return to work normally not earlier than in 2-4 months. Some of the patients lose the ability to work and goes on disability.
Brain injury (contusio cerebri) - mechanical damage to brain tissue, accompanied focal disorders of Central nervous system function.
Symptoms depend upon the nature and localization of the primary lesion and perifocal phenomena dependent on disorders of the blood and liquorrhea. When placing a contusion of the hearth in functionally significant areas (front and back Central gyrus, left temporal lobe etc) occur persistent phenomenon of loss functions (motor, sensitive, speech, hearing, sight, and others), as well as cerebral symptoms of brain damage (violation of consciousness, headache, agitation, confusion and other)associated with the violation of hemodynamics, litwareproposal, edema and swelling of the brain, increased intracranial pressure. Cerebral symptoms appear and grow later focal before regressing in recovery. The prognosis depends on the severity of damage and durability focal symptoms.
The compression of the brain (compressio cerebri) is developing at a rapid increase in intracranial pressure due to intracranial bleeding from damaged blood vessels Dura, venous sinuses veins and bones of the skull, if depressed fractures of the skull bones, acute edema and swelling of the brain.
In the development of the syndrome is the compression of the brain there are latent phase, which is characterized by the signs of shock (loss of consciousness) and brain injury, followed by "light", asymptomatic period of varying duration, during which the patient is conscious, and the third phase is detected oppression CNS functions, disturbed consciousness up to coma, grow changes cardiovascular activity and respiration. The sequence and the severity of the individual phases depend on the rate of compression of the brain. Forecast serious.
Closed injuries of skull and brain
With a closed craniocerebral injury damage content skull leads to the changes inherent in the concussion, compression and injury of the brain in their pure form or in different combinations with each other (see a Concussion, compression of the brain, brain Contusion).
