In addition to the clinical symptoms of brain clearly traced focal characteristic of the affected area of the brain. There are 3 degrees of brain injury: mild, moderate, severe.
Symptoms of brain injury
Mild mind off from a few tens of minutesto several hours (1-3 hours). Moderately expressed cerebral symptoms: amnesia (memory loss), nausea, vomiting. Man worried headache, dizziness. There are focal symptoms: impaired motor and sensitivity to side of the body opposite to the site of brain injury; speech disorders, vision; paresis of mimic muscles of the face and tongue muscles (muscle weakening active motor abilities); easy anisocoria (inequality magnitude of the pupils); nystagmus (involuntary oscillatory movement of the eyes).
With an average degree mind off from a few tens of minutesto days. Patients expressed amnesia observed mental disorders, anxiety, repeated vomiting. Changes heart rate (tachycardia or bradi-), increased blood pressure and body temperature (low-grade, 37-37.5), breathing quickens without arrhythmias. Pronounced focal symptoms: impaired pupil reactions, oculomotor disturbances, nystagmus, paresis of limbs, numbness. Gradually over 3-5 weeks. focal symptoms are smoothed out. The sharp increase in intracranial pressure causes the disorder of the central nervous system.
brain contusion to severe characterized by switching off the consciousness ofseveral hours to several weeks. Expressed and long remain focal symptoms caused by lesions of the brain stem: hyperthermia (up to 39-40 ° C), a disorder of the respiratory rhythm, or bradi- tachycardia, hypertension. Dominated by neurological symptoms: violation of the diameter and the reaction of pupils to light, eye movement disorders, depression corneal reflexes (reflex closing of eyelids with a light touch) and swallowing, and others. The general condition remains extremely serious for many days, and often ends in death.
If the positive dynamics of cerebral and focal symptoms disappear slowly, and motor and mental disorders remain for life.
Treatment of brain injuries
The main treatment is aimed at combating acuterespiratory failure - airway (introduction duct intubation, mechanical ventilation, inhalation of oxygen). To combat increased intracranial pressure in / injected glucose, urea, mannitol, lasix, novocaine. To reduce the body temperature / m prescribed analgin aminopyrine and 3-4 times a day. combined lytic mix (diphenhydramine, pipolfen, chlorpromazine, Tisercinum, pentamin) entered with severe brain injury. Held transfusion therapy to 3-4 liters per day. To improve supply of oxygen to the brain is introduced into / 20% sodium hydroxybutyrate (GHB) in 40-80 ml per day.
Peculiarities of nursing care for patients with severe traumatic brain injury (pneumonia prophylaxis, oral care, feeding patients, and others.) Are considered at the end of the chapter.
All people with a brain injury, even lightextent, require strict bed rest for at least 1 month. Monitoring their condition at the time of the treatment is carried out neurologist, ophthalmologist, and after rehabilitation, patients are seen in the mental hospital.