Traumatic brain injury syndrome

  If the above symptoms persist for more than 3 months and there are no obvious positive signs in the neurological examination of these patients, they can be diagnosed as traumatic brain injury syndrome.  The main pathogenesis of the symptoms is the stasis of blood in the brain, which has not been cleared, and the post-injury stasis makes it difficult for qi and blood to be injected into the brain, resulting in the brain losing its nourishment and the medulla oblongata. “Blood stasis leads to qi stagnation, and qi stagnation leads to blood stagnation, which is called “non-passage leads to pain”. Blood stasis after traumatic brain injury is often accompanied by blood deficiency, especially in patients with prolonged post-traumatic illness, and the heart loses its nourishment, making it difficult for the patient to master the mind or suffer from deficiency of qi and blood.  Clinical manifestations: Headache is the most common symptom, which can be sharp, dull or pulsating pain and can appear throughout the head, frontal or occipital region. Pain in the occipital region is usually accompanied by pain and tension in the muscles at the back of the neck. The onset of headache is indefinite and can be aggravated by poor mood, fatigue, insomnia, and consequent agitation. A definite cause of post-traumatic headache is the loss of cerebrospinal fluid, which causes headache due to low intracranial pressure. However, most people with persistent, or even fairly severe, cerebrospinal fluid leak do not have significant headaches, so the overproduction of cerebrospinal fluid is perfectly capable of replacing the lost amount.  Dizziness manifests itself in a variety of ways, often complaining of dizziness, tinnitus, and nausea, exacerbated by changes in body position. Hypersensitivity and irritability are also common and are usually caused by stressful environmental factors. In addition, memory loss, difficulty concentrating, easy fatigue, diminished intelligence, and insomnia may be the result of psychological factors.  Autonomic dysfunction is manifested by palpitations, blood pressure fluctuations, excessive sweating, menstrual disorders, and sexual dysfunction.  It has been reported in the literature that symptoms after traumatic brain injury are sometimes related to the site of injury. Fewer symptoms are seen after frontal injury; vertigo and memory impairment are seen in about half of the cases after temporal injury; and difficulty in concentration, hypersensitivity, and easy fatigue are mostly seen in those with parietal trauma.  Diagnosis: The diagnosis of traumatic brain injury syndrome can be determined only after excluding intracranial organic lesions. Necessary tests such as lumbar puncture, EEG, CT, MRI, etc. should be performed. In some cases, small soft foci scattered in the brain parenchyma can be found on MRI. In most patients, the neurological examination is normal and the neuroradiological examination is also normal. Although, many post-traumatic brain syndromes are caused by psychological and social factors. However, it cannot be said that all post-traumatic syndrome is a personal psychological problem. Detailed information about the injury, examination and laboratory results, treatment process and outcome should be obtained. Express concern and understanding for the patient’s statement that each symptom, although mild, is combined enough to be serious enough to make a person unable to work normally. Help the patient to release his or her concerns about brain injury and build confidence in curing the disease by combining medication.  Safety and life care ① Pay attention to the quietness of the living room, the light should be dark, reduce all the interference to the patient.  ②. When the patient’s memory and intelligence are impaired, it is difficult for him to express the symptoms, so the symptoms are hidden, atypical and coexist with multiple diseases. It is necessary to observe the changes of the disease carefully and comprehensively.  ③. Do not change the old habits of patients in the chronic stage. For example, wake up early, wash up, eat, place things, etc. can be left to nature. Try to encourage individuals to take care of themselves and do things they like. Enhance the patient’s sense of responsibility, such as being responsible for opening and closing doors and windows, cleaning bedside tables, sweeping floors, etc., so that he or she can maintain confidence in life.  ④ Maintain the regularity of living, eating and sleeping. Gradually develop good living habits.  ⑤ Patients with psychiatric symptoms should pay attention to avoiding various factors that stimulate psychiatric symptoms.  ⑥Give adequate nutrition and hydration as needed, nasal feeding or intravenous high nutrition if necessary.  Psychological care ① Pay attention to the basic techniques of supportive psychological care, respect and care for the patient, and strengthen communication. Help the patient understand the nature of the disease, relieve concerns, and understand in detail the patient’s situation as well as that of family members and friends, in order to establish good interpersonal relationships and solve practical problems. Promote early recovery.  ②Patients with personality changes due to traumatic brain injury need to strengthen psychological education to help them understand the existence of personality problems. Gradually learn to control and overcome bad behavior. And pay attention to the work of family members, and other people around, to help them correctly treat the patient’s pathological behavior, and properly resolve the patient’s difficult and tense interpersonal relationships.