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Mechanical damage to the human cranium along with its contents, which are manifested by established neurological symptoms, is called a traumatic brain injury. Timely first aid for traumatic brain injuries helps to save the life and many functions of the victim’s body, so it is extremely important to know all the basics of behavior in such a situation.
The main causes and types of injuries in the skull area
The studied pathologies can occur due to many factors, for example, in traffic accidents, falls from a height, at work and at home, while playing active sports.
The main types of traumatic brain injury include closed, open and penetrating head injuries. The closed form of such injuries includes those during which the aponeurosis remains intact, but there are injuries or bruises of the head in the soft tissue section. Open craniocerebral injuries are characterized by damage to the aponeurosis and integrity of the skin on the head. Experts refer to penetrating injuries as those resulting in the violation of the integrity of the hard shell of the brain.
Clinical course of pathology
More often than others, with craniocerebral injuries, a concussion of the brain occurs without macrostructural lesions. Brain damage at the cellular level is reversible and treatable. The main symptoms of a concussion are loss of consciousness for a short time, nausea and vomiting, dizziness, headaches, double vision, sweating, memory loss. From a neurological point of view, there is a violation of symmetry in the tendon reflexes, small-scale nystagmus, which under normal conditions disappears a week after the injury. If the victim undergoes a computer or magnetic resonance imaging, they will not reveal any pathologies.
Traumatic brain injury can cause contusion of the brain. This pathology leads to hemorrhages and destructions (gross macrostructural disorders) in the brain, accompanied by subarachnoid hemorrhage. Often a brain injury is accompanied by a fracture of the bones of the skull. All this in combination can lead to edema of the brain substance.
Manifestations of brain contusion according to severity:
- Mild degree – the loss of consciousness of the patient can last up to 20 minutes, after which dizziness, vomiting and nausea, headaches, anterograde or retrograde amnesia occur. Vital functions remain unchanged; cardiovascular changes may occur in the form of hypertension or bradycardia. Neurological symptoms include pyramidal insufficiency, clonic nystagmus, and mild anisocoria.
- At the middle stage, the unconscious state of the patient lasts several hours, after which there is a pronounced memory loss, repeated vomiting, mental health is disturbed. Vital functions are impaired, persistent bradycardia, tachypnea with preservation of airway patency, hypertension. From a neurological point of view, there is nystagmus, a violation of symmetry in tendon reflexes and muscle tone, various meningeal signs. Focal manifestations in the form of oculomotor and pupillary disorders, changes in speech, paresis of the limbs are also obvious.
- In severe cases, the patient falls into a coma, which, if not fatal, can last for several weeks. Gross violations of vital functions carry a threat to life. At the same time, the movements of the eyeballs are floating, the rhythm and frequency of breathing are disturbed, bilateral miosis or mydriasis, convulsions occur. With such traumatic brain injuries, there are fractures of the bones of the skull in combination with massive subarachnoid hemorrhage.
There may be compression of the substance of the brain by intracranial hematomas that form above or below the pia mater.
According to the clinic, squeezing can manifest itself in the same way as a bruise, but it has a very dangerous consequence. After the victim returns to consciousness, it usually becomes easier for him, but this does not last long, until the intracranial hematoma grows in size and begins to compress the brain. After that, the person again falls into a coma, and the prognosis of such a state is rarely satisfactory. The work of the respiratory and vascular centers is disrupted.
First Aid
In order to prevent many negative consequences after a person has received a traumatic brain injury, he should quickly provide first aid. The health and life of the victim largely depend on its quality and timeliness. However, all manipulations should be done only after an ambulance is called so that this process is not delayed.
When providing first aid for a traumatic brain injury, it is important to find out if the person is conscious. You should try to wake him up, check how he reacts and whether he reacts at all to pain. Next, the site of the injury must be carefully examined to understand whether it is open or closed, whether there are external bleeding, liquorrhea, leakage of cerebrospinal fluid.
Next, the victim’s breathing and pulse are assessed. Before the ambulance arrives, it is important to understand whether a person has bradypnea or tachypnea, whether aspiration is present, whether tachycardia, bradycardia occurs, whether there is a pulse. If there is no pulse, it is necessary to start rehabilitation procedures (heart massage, artificial respiration). In the absence of consciousness, it is necessary to assess the patency of the respiratory tract, if necessary, they are cleaned of foreign bodies or compressive elements.
When an open injury is detected, it is important to apply an antiseptic bandage to the head in a timely manner. When viewing fragments of bone or brain tissue, the bandage is applied in a circle on the head in the form of a ring. If the victim has liquorrhea, then the ear canals and nasal passages must be plugged with clean gauze bundles.
In an unconscious state, a person is laid on either side to prevent asphyxia or aspiration.
If you suspect a fracture of the spine and the presence of consciousness, the victim is not touched until the arrival of doctors. They try to apply cold to the injured place. If it is necessary to independently transport the victim to the hospital, it is necessary to carry him lying down, monitor the pulse every 10 minutes and maintain airway patency.
When providing first aid for traumatic brain injuries, it is impossible to plant the victim, even if he insists on it, to allow him to move or change his position while lying down for no apparent reason. It is also categorically impossible to remove bone fragments and so on from the wound, since in this way severe bleeding can be provoked. It is unacceptable to leave a person alone without control, since his condition may deteriorate sharply after some time. It is also forbidden to independently try to anesthetize the wound by administering analgesics.
If first aid is not provided to the victim in a timely and competent manner, then a fatal outcome in case of craniocerebral injuries is 70% likely. That is why it is so important to know how and how to help the victim before the arrival of the medical team and the start of qualified rehabilitation in the hospital.