Concussion (neurosurgery) is a transient brain dysfunction that occurs immediately after a blow to the head from an external force. There is no significant change in pathological changes and the mechanism of occurrence is still much debated. Clinical manifestations are transient coma, near event amnesia and symptoms such as headache, nausea and vomiting, with no positive physical findings on neurological examination. It is the mildest form of brain injury and is mostly curable with treatment. It can occur alone or in combination with other cranial injuries such as intracranial hematoma, and attention should be paid to make a timely differential diagnosis.
Symptomatic manifestations.
1, impairment of consciousness: the degree of light and brief, can be as short as a few seconds or minutes, but no more than half an hour.
2.Proximal amnesia: After waking up, you cannot recall the situation and the injury, but you can clearly recall the events before the injury.
3.Other symptoms: often headache, dizziness, nausea, anorexia, vomiting, tinnitus, insomnia, photophobia, inattention and unresponsiveness, etc. 4.No positive signs on neurological examination.
Diagnosis based on.
1, transient coma occurred immediately after the head injury, within 30 minutes, and after waking up, there were often symptoms such as forgetfulness of near events, headache, dizziness, nausea, anorexia, vomiting, tinnitus, inattention, etc. Blood pressure, respiration and pulse were basically normal.
2. No positive signs in neurological examination, and normal cerebrospinal fluid pressure and composition in lumbar puncture examination.
Treatment principles.
1.Patients with concussion should stay in hospital for 2-3 days after injury for short-term observation, and regularly observe the changes of consciousness, pupils and vital signs in order to detect possible complications of intracranial hematoma.
2.Appropriate bed rest, reduce mental and physical work.
3.Symptomatic supportive treatment.
4.Spiritual encouragement and elimination of worries.
Medication principles.
1, headache and insomnia can be given analgesic and sleeping agent treatment respectively.
2, vomiting early after the injury is obvious and affects eating, intravenous fluid supplementation.
General knowledge of prevention.
Concussion can be diagnosed according to the symptoms and signs after the injury. Since the brain injury is mild, the treatment is mainly symptomatic, such as giving analgesics to those with headache, giving fluids to those who vomit obviously and cannot eat, and it is advisable to rest quietly in the early post-injury period, think less about problems and read newspapers, and pay attention to reduce the adverse stimulation to the patient. After several days or weeks of treatment, most of this disease can be cured. Since the disease can be combined with intracranial hematoma, it is best to stay in the hospital for a period of observation and treatment (about 5 days) after the injury, so that the intracranial hematoma can be diagnosed and treated in time once it is found.
For patients who go home, relatives and friends should closely observe the patient’s state of consciousness for 1-2 days, pay attention to symptoms such as headache, vomiting and restlessness, and immediately go to the hospital for CT examination if the condition worsens, so as to clarify the diagnosis. Due to damage to brain tissue from head trauma, loss of consciousness occurs initially, and after recovery, there are mostly symptoms such as amnesia, retrograde amnesia, Korsakoff syndrome, neurasthenic state, and personality changes. The changes in brain tissue that are not visible to the naked eye are called concussions. A partial destruction of brain tissue is called a cerebral contusion. Concussion may be a characteristic symptom due to total dysfunction of brain tissue. The pathogenesis may be considered to be due to impaired blood circulation to the brain, subarachnoid cerebrospinal fluid circulation and impaired medulla oblongata.
The common symptom is a momentary trance or loss of consciousness immediately after the head injury.
It lasts from a few seconds to 20 or 30 minutes, and returns to normal after waking up, but there is no memory of the injury and its occurrence. In addition, headache, dizziness, nausea and vomiting occur. Concussion is the mildest form of cranio-cerebral injury and can generally heal on its own with bed rest and symptomatic treatment. However, during the treatment process, attention should be paid to the combination of more serious cerebral contusions and cranial hematoma. Therefore, the condition should be closely observed, especially pay attention to the pulse, respiration and changes in mental status. If necessary, further examinations, such as lumbar puncture, cranial X-ray, ultrasound and CT, should be performed in order to make immediate diagnosis and corresponding treatment.
How to treat the headache caused by acute concussion with Chinese medicine?
Acute concussion-induced headache has a clear history of traumatic brain injury, followed by coma or momentary confusion of varying degrees after the injury, lasting for a few seconds or minutes, rarely more than 30 minutes. After waking up, the headache is severe, mostly distending and dull in nature, often accompanied by vertigo, tinnitus, photophobia, vomiting and other symptoms, and the headache is obvious within a few days after the injury and gradually improves within 1 to 2 weeks. The phenomenon of forgetting recent events, i.e., not being able to remember the situation at the time of the injury and the events after the injury, but recalling past events very clearly