Concussion brain in children

Content

  • Brain-brain injury
  • Manifestations of concussion of the brain
  • We take urgent measures
  • Diagnostics
  • Tactics of treatment



  • Brain-brain injury

    According to the severity of the brain injury
    divided into light (concussing brain), moderate severity
    (brain injury light and medium severity, with possible
    fractures of the bones of the skull) and heavy (brain bruises
    severe, intracranial hematomas with brain squeezing, fractures
    The base of the skull). Fortunately, up to 90% of Children's CMT accounts for
    concussion brain, which will be discussed in this article.

    A high level of injury in children is explained by the increased
    the motor activity of the child, his restlessness and
    curiosity that combines with the imperfection of the motor
    skills and coordination of movements, as well as a reduced sense of danger and
    Fear of height. In addition, young children have a head
    relatively large weight, and the skill of insurance with their hands is not yet developed,
    Therefore, small children fall, as a rule, down their heads and hands are not
    Substitute.

    Causes of children's chmt are very specific for each age group.
    Newborn in the total mass of victims make up 2%, breast kids
    Age — 25%, nursery — 8%, preschool — 20% and school age
    45%.

    Concussion brain in children
    Injuries in babies — This is primarily the result of the inattention and
    The carelessness of their parents. Children up to 1 year most often (more than 90%!)
    Get injuries to the head after falling from changing tables, beds,
    From the hands of parents, from wheelchairs and t.NS. Never leave baby
    one in the place where he can fall. If you need to move away from the child
    per distance, more than in a pulling hand, do not be lazy, put
    him in the crib, in a stroller with sides, in a playpen! One or two seconds
    It happens enough to kroch to roll towards the edge of the changing table
    and fell.

    Starting from 1 year old kids start walking. The main reason
    CMT becomes a fall from the height of one's own growth, and a little later —
    Falls with stairs, trees, roofs, windows, slides, etc. Episode Himself not
    always manage to reveal. It should be borne in mind that if a child
    remained under the supervision of relatives, neighbors or nanny, then they can
    Hide from parents Fact Fall Baby.

    Older children themselves for various reasons
    Often drag injury. In addition, children may damage
    brain without immediate injury. These damage usually
    occur when exposed to the body of a sharp acceleration or
    Brakes (syndrome «Shake baby»). Syndrome «Shake
    child» most often observed under the age of 4-5 years and can
    arise with rough circulation, jumping from height to feet, and in children
    younger age even when they are excessively intense tech.



    Manifestations of concussion of the brain

    When concussing the brain in it does not happen,
    irreversible changes, and such injury, being the most frequent, has
    the best forecast and very rarely leads to complications.

    It should be remembered that the cerebral of the child (and especially the infant)
    significantly different from the brain of an adult. Picture of concussion
    The brain in adults is significantly different from this
    Injuries in the child.

    In adulthood, the concussion of the brain is manifested
    The following main features: Episode loss of consciousness from several
    seconds up to 10-15 minutes; nausea and vomiting; headache; amnesia
    (dropping out of memory) Events related to injury (before injury, herself
    injury and after injury). In addition, some specific
    neurological symptoms, such as nistagm (vent
    Apples), disruption of coordination of movements and some others. Painting
    shaking brain in a child completely different.

    In children under 1 year old, the concussion of the brain is usually,
    Malosimptomno proceeds. The loss of consciousness does not happen more often, notes
    Single or multiple vomiting, nausea, jerking when feeding,
    skin pallor, unfortunate concern and crying, elevated
    drowsiness, lack of appetite, bad sleep.

    Preschool children often manage to establish fact
    loss of consciousness, nausea and vomiting after injury. They are noted
    Headache, Beating or Slowing Pulse, Unstable
    blood pressure, pallor of skin, sweating. Wherein
    It is often noted by capriciousness, plasticity, sleep disorder.

    Sometimes children have such a symptom as post-traumatic
    blindness. It develops immediately after injury or a little later,
    persists for a few minutes or hours and then
    independently disappear. The reason for this phenomenon is not clear.

    Features of the children's body lead to the fact that long
    Compensation status can change the rapid deterioration. That
    There is immediately after the fall, the child feels satisfactory, but
    after a while it appears and starts to increase quickly
    Symptomatics.


    We take urgent measures

    What to do parents whose child got a cranial brain
    injury? The answer is one — the child should necessarily and urgently
    show a doctor. It's best to call «ambulance», that
    Be sure to take the child to a hospital having children's neurosurgeons
    or neuropathologists. And this measure is not excessive. With minimal
    symptoms and complaints in the kid can be difficult damage
    brain. Prolonged visible child well-being
    symptoms, especially with hemorrhages in the brain, often
    A few hours later, and even days is replaced by progressive deterioration
    states that begins with changes in the child's behavior, its
    increased excitability, may be nausea, vomiting, nystagm,
    Breasts blows the spring, then drowsiness appears, observed
    Depression of consciousness.


    Diagnostics

    In the hospital, a child inspects a children's neuropathologist, neurosurgeon or
    traumatologist. He carefully finds out the complaint, collects anamnesis (story
    Diseases) conducts a general and neurological examination. Appointed
    Additional diagnostic methods. Radiography are basic
    Skulls, neurosonography (in young children), echo encephalography
    (Echo EG). If necessary — Computer tomography brain
    (CT), magnetic resonance tomography (MRI), electroencephalography (EEG),
    Lumbal puncture.

    Radiography skulls are carried out most of the patients. Purpose
    This study is to identify the fractures of the skull. Availability
    any damage to the bones of the skull automatically translates the injury in
    The discharge of medium-heavy or heavy (depending on the child's condition).
    Sometimes young children with a prosperous clinical picture on
    Radiographs revealed linear fractures of bones of the skull. Judge O
    The state of the substance of the brain on radiographs is impossible.

    Neurosonography (NSG) — This is an ultrasound study
    brain. On neuralonograms, a substance of the head is clearly visible
    Brain, ventricular system. You can identify signs of head edema
    Brain, foci of injury, hemorrhages, intracranial hematomas. Procedure
    simple, painless, quickly executed, does not have contraindications.
    It can be revealed repeatedly. Single limit
    neurosonography — The presence of the so-called «Natural ultrasound
    windows» — large spring or thin temporal bones. Method is very
    Effective in children under the age of 2 years. Later ultrasound
    It becomes difficult to pass through the thick bones of the skull, which is sharp
    worsens image quality. Equipment for execution
    neurosonography is available in most children's hospitals.

    Concussion brain in childrenEcho-encephalography (Echo EG) — It is also an ultrasound method
    Research that allows you to identify the displacement of the middle line structures
    brain, which may indicate the presence of additional
    bulk brain formations (hematoma, tumor), give
    indirect information on the state of the brain substance and
    ventricular system. This simple and fast method, however reliability
    His low. He used to be widely used in neurotramatology, but
    with modern diagnostic tools, such as
    neurosonography, computer and magnetic tomography, from him
    You can completely refuse.

    The ideal method of diagnosing damage and brain diseases is computed tomography
    (CT). This is a radiological research method at which with high
    Clarity You can get images of the bones of the skull and substance of the head
    Brain. Almost any damage to the bones of the arch is diagnosed on CT
    and the base of the skull, hematomas, the foci of the injury, hemorrhage, foreign
    body body skull and pr. The accuracy of this study is very high. His
    The main disadvantage is that the CT apparatus of roads, and it is
    far from every hospital.

    Magnetic resonance tomography (MRI) — the most accurate but
    Complex and expensive method of examination of the central nervous system. He
    rarely used to diagnose acute acute brain injury so
    How does it not allow to see the bones of the skull, less accurate for recognition
    sharp hemorrhages, takes more time than computer
    Tomography often requires anesthesia when examining young children —
    The child should lie absolutely motionless for 10-20 minutes, and
    Little children cannot do this; Also very few
    Clinics can boast the presence of magnetic resonance tomographs.

    Electroencephalography (EEG) allows you to learn
    Bioelectric brain activity. It is used by
    Special indications for assessing the severity of the cranial brain
    Injuries, detecting foci of epileptic activity. The focus of epiacivity
    — Scope of the cerebral cortex with pathologically modified activity
    neurons (nerve cells) that can lead to occurrence
    epileptic attacks.

    Lumbal puncture — This is a fence of a liquid (fluid ishing
    head and spinal cord) from the spinal cord on the lumbar
    Level. Changes in liquor may indicate injury or
    hemorrhage (presence of blood) or inflammatory process, meningitis.
    Lumbal puncture is extremely rare and only on special
    Indications.


    Tactics of treatment

    After the baby fell, before he examines the doctor, help
    The child is to create a relaxing situation. Need to lay
    Baby, to ensure peace. If there is bleeding from the wound,
    make it possible to process and binting.

    In addition to the diagnostic procedures in the reception room, the hospital is carried out
    Processing of damage to the soft tissues of the head (bruises, abrasion, wounds). Children,
    Especially early age, with a confirmed brain injury, in
    including with a concussion of the brain, are subject to mandatory
    hospitalization.

    Hospitalization has several goals.

    First, within a few days, the child is under control
    doctors in hospital conditions for early detection and prevention
    Complications of injury — brain edema, intracranial appearance
    hematoma, epileptic (convulsive) attacks. The probability of these
    complications are small, but the consequences of their extremely heavy and can lead to
    catastrophically rapid deterioration of child. Therefore, when
    Brain concussion Standard hospitalization period is
    week. With good technical equipment in the hospital (computer
    Tomography, neurosonography), allowing to eliminate heavier
    Brain damage, the period of stay in the hospital can be reduced to 3-4
    Days.

    Secondly, during hospitalization, the patient provides the creation
    psycho-emotional rest. This is achieved by the engine limit and
    Social activity of the child. Certainly achieve completely
    beddown for children is difficult, but still the conditions of the hospital are not
    allow running, noisy games, long watching TV, seats for
    Computer. After discharge, the home mode is preserved during
    1.5-2 weeks, a few weeks are limited to sports.

    Medical therapy with a concussion of the brain has
    Several goals. First of all, the child is appointed diuretic
    Preparations (most often diakar, less often — Furosemide) in mandatory
    Combinations with potassium preparations (Asparkama, Panangin). This is done for
    Prevention of edema of the brain substance. Conducts soothing
    Therapy (phenozepam, infusion of Valerian root) and are prescribed
    Antihistamines (Suprastin, Diazolin, Dimedrol). With heads
    Analgesics (barallgine, sadalgin) are appointed pain, with pronounced
    Nausea — Cerucal. In later dates, nootropic
    Preparations that improve the exchange processes in the brain, vitamins.

    Monitoring the condition of children is carried out by attending and duty
    doctor as well as post nurses. In case of any deterioration
    A re-examination of the child is carried out, additional
    Diagnostic studies (neosonography, computed tomography,
    EEG).

    Offering to go to the hospital, the doctor first of all cares about
    Do not miss heavier than concussion brain, injury,
    And this is possible only with a qualified observation of the child.

    With a satisfactory condition of the baby in a few days
    Parents can pick it up on receipt. However, at home required
    Observe the medical and security mode, limit the view
    TV, games on a computer, walks, visiting friends, continue
    Medical therapy. With any suspicion of deterioration
    child (the appearance of nausea and vomiting, headaches, unmotivated
    drowsiness, convulsive attacks, appearance of weakness in the limbs,
    Frequent shinking from kids) should immediately turn to
    doctor for reassembly and possible hospitalization.

    As a rule, after 2-3 weeks the condition of the child is fully coming in
    norm. Concussion of the brain usually passes without consequences and
    Complications. The child can visit the nursery and kindergarten, engage
    Sports.

    In conclusion, it is once again necessary to emphasize the importance in a timely manner
    appeals to a specialized children's hospital, which will allow
    eliminate the heavier forms of the brain injury.

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