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Damage to the brain tissue after exposure from the outside, resulting from contact with the bones of the skull, is called a concussion. This injury can occur not only from a bruise or blow to the head, but also from a sudden movement. A car accident, a domestic or work injury, sports competitions – in all these situations, there is a possibility of getting a concussion.
If in the first minutes after the injury there is a person nearby who is able to provide qualified assistance, some complications can be avoided and the rehabilitation period can be significantly reduced. A concussion is classified according to the degree of damage to the meninges. With a mild form, the patient receives outpatient treatment, with moderate and severe – medical care is provided exclusively in a hospital setting.
Signs of a concussion
To assess the condition of an injured person, you need to know the main signs of a concussion:
The main symptom is loss of consciousness, which can last from several minutes to several hours;
Nausea and vomiting that appeared after the restoration of consciousness;
Intense headache, dizziness;
Not symmetrical pupil sizes;
Lack of focus, double vision or blurred vision;
Convulsions;
Photophobia, intolerance to strong sounds;
Drowsiness, weakness, general malaise;
Impaired coordination of movement;
incoherent speech, uncoordinated movements;
Body temperature close to normal.
With a mild degree of concussion, only a few of the above signs are diagnosed. The body of a child can react with similar symptoms even to a minor injury.
What to do with a concussion?
Doctors briefly characterize the basic requirements for measures taken in case of concussion: “Hunger, cold and rest.” They are followed during the treatment of the patient in a hospital or at home. Before he is provided with qualified assistance, it is necessary to alleviate the condition of a person with a similar injury, reduce the risk of possible complications.
The algorithm of actions in the first minutes after a concussion before the arrival of an ambulance:
If the victim is conscious, he should be laid on a flat surface with a raised headboard.
An unconscious patient may die due to suffocation due to the ingestion of vomit into the lungs or the sinking of the tongue. To avoid this, you need to put the injured person on his right side, carefully turn his head face down and to the right, bend his left arm at the elbow and left leg at the knee. Before this, you need to make sure that a person with a concussion does not have fractures of the limbs.
To facilitate breathing, remove restrictive clothing, loosen belts, belts, ties, scarves. If the air is cold, you need to cover the patient with a blanket. All these measures are impossible with visible signs of spinal cord injury – numbness of the limbs and loss of sensitivity. In this state, it is generally impossible to carry and turn the victim over.
Ice is applied to the head, in its absence – any products from the freezer of the refrigerator.
Wounds on the head are treated with any aseptic solution, a sterile bandage is applied.
For pain relief, give the victim, who is conscious, analgesics. Any portion of the liquid can provoke profuse vomiting in a person with a concussion, so it is undesirable to drink it or give only a minimum amount of water or sweet cool tea.
For complete control over the situation, it is impossible to allow the victim to fall asleep, to fall into an unconscious state. He is talked to during the first hour after the injury, and if possible, asked to answer questions.
If possible, the patient is transported on a hard surface to a medical institution independently by any available transport.
It is strongly not recommended to feed the victim even with a mild degree of concussion in the first hours after the injury.
Any drugs are prescribed by the attending physician after a thorough study of the depth of brain damage.
What tests need to be done?
Diagnostic measures will help to obtain an objective clinical picture of brain damage:
radiography of the cervical vertebrae and bones of the skull – determines the possible displacement of the vertebrae, cracks, bone fractures;
encephalography, echoencephaloscopy – determines possible focal lesions of blood vessels;
CT (computed tomography) – determines changes in brain structures in complex combined injuries;
fundus examination – determines probable hematomas, hemorrhages after a brain injury.
Compliance with the daily routine
After a complete examination and prescription of medications by a doctor, a patient with a mild form of concussion can continue to treat concussion at home.
To quickly restore health, you need to follow these recommendations:
With any degree of concussion, it is recommended to observe bed rest from 3 to 5 days. A sick leave for this injury is issued on average for 10-14 days.
It is necessary to temporarily stop using a computer, TV, smartphone, reading ordinary books and using their electronic counterparts, and communicating in large volumes.
Patients are not recommended psycho-emotional overload. Their relatives should protect their relatives with a concussion from experiences, stressful situations.
With photophobia, it is desirable to create a subdued light background in the room, cover the windows with blinds, thick curtains.
The relief of headaches, often observed after a concussion, is carried out without fail with drugs prescribed by a doctor in the recommended dosage.
Symptoms of a mild form of the disease are significantly reduced after 3-7 days with careful implementation of the above recommendations. The lack of positive dynamics, the deterioration of the patient’s health should cause alertness. Bleeding from the nose and ears is especially dangerous. In this case, urgent medical attention is required.
Prognosis of the disease
In the absence of complex combined lesions of the central nervous system and careful observance of medical recommendations, the injury does not leave any complications and ends with complete rehabilitation.
Within 3-12 months after a concussion, some patients may experience the following symptoms:
Decreased memory;
Decreased concentration;
Manifestations of depression;
causeless anxiety;
Headache;
Insomnia;
Intolerance to bright light and loud sounds;
Over time, these manifestations completely or partially “vanish”.
When can I exercise after a concussion?
There is no consensus among specialists in sports medicine about the return to full-fledged sports. In most cases, a step-by-step approach is used to return to full-load training. It consists in the complete relief of symptoms and a return to sports through low-intensity training. If the monitoring of vital signs has shown good results after some time, it is recommended to gradually increase the load until it returns to the previous level.
The solution to the problem of rehabilitation of athletes with concussion was proposed in 2013 at a scientific conference of sports medicine specialists.
The system of increasing the load after a brain injury:
Full rest during the day after the complete relief of symptoms of concussion.
Performing light aerobic activities (walking).
Performing specific exercises for each sport, excluding even accidental blows to the head.
The transition to non-contact types of loads (for example, in basketball – practicing throws).
Implementation of a program of full-fledged training with physical contact.
Transfer to the playing team.
The absence of concussion symptoms suggests that it is possible to resume training within a week. Incomplete recovery, deterioration in health indicates the need to take a step back according to the proposed scheme. A short rest will allow you to move further along the path of rehabilitation.