Our specialists in the field of neurosurgery and maxillofacial surgery on
international conferences, to put it mildly, «Surprise» Foreign colleagues
statistics on injuries received by Russians as a result of the most severe
Drak. The patients «Overseas» Doctors are mostly sacrifice
Production and Road Cases. Why is so high
aggression from us and what a man threatens «innocent» concussion of the brain,
obtained when clarifying relationships or for any other reason? What
need to know and what to do if the head injury still happened?
About this and how dangerous injuries are told
Association of the Department of Traumatology of the Russian Medical Academy
Postgraduate Education Nikolai Nikitich Ships and Evgeny Sergeevich
Signs of injury
A feature of modern injuries is absolutely high
Mortality at young age. Even among patients surgical
Profile The share of traumatological patients accounts for over 50%.
Among the cranial and brain injury (CMT) allocate:
- Concussion brain without indication.
- Three degrees brain injury (light, medium, heavy).
- Traumatic intracranial hemorrhages.
Combined damage to the skull and brain:
- bruises and injuries of soft tissues of the skull with a trauma of the brain, its shells and vessels;
- closed fractures of the bones of the skull with damage to the brain (injury, concussion), with damage to its shells and vessels;
- Fracture of bones of the base of the skull with damage to the brain, shells, vessels and cranial brain nerves.
Damage to the brain barrel without a manifestation of the clinic.
Ears are different
Among frequent injuries can be called brain bruises,
which are distinguished by gravity (light, medium, heavy),
location and depth of damage. Foci of lesions of cerebral tissue
may be in the hemispheres of the brain, on their surface,
base, in cerebellum and stem department. Of course, the diagnosis is the case
doctor, but for what signs you can determine what kind of damage
in humans, especially if he refuses or is in no hurry to seek
Ears of the surface layer of gray cerebral hemispheres (bark) relate
to the ears of easy degree. Loss of consciousness in such patients continues
up to three hours, then a few days there is a stunning. Pupils
a person is evenly narrowed, photoreacts for the light of living. Victim
Periodically nauseous, marks vomiting.
Middle Degree Brain Ears accompanied by damage
Brain fabric deeper layers located under the crust. In that
Case loss of consciousness can last 2-3 days. Reaction of pupils for light
Sloggy. Quite often arise cramps.
Ears of severe degree accompanied by extensive
hemorrhages. In this case, the unconscious state continues
up to two weeks. Photoreacts for light bad, convulsive seizures are frequent and
Long. There are gross respiratory disorders, swallowing,
cardiovascular activity, involuntary urination and
Beaching Cala. Gross violations of the consciousness of patients with head bruises
Middle and severe brain are associated with brain lesions.
Special place occupies Summifying the head, which is observed
with earthquakes, destruction of houses, industrial buildings, falling with
Heights on the head, traffic accidents (air, railway,
car). Kinetic energy literally can split the head,
like nut! Soft tissue heads are injured, bones break.
With another common injury - concussion brain -
There is a short-term loss of consciousness, retrograde amnesia
(memory loss), light fast reversible general-selling symptoms.
Injuries most often leave explicit traces, and it is very important to pay for
These are attention. Diagnosis of brain and skull damage is built
Based on availability, evaluation «combat» Injury signs. These include:
Eugene, wounds of the scalp, earliest areas, bruises of soft
fabrics and, naturally, hematoma (bruises), their location and increase.
Evaluation is important «Tracks» bleeding from the nose, from the ears and time
appearance. No matter how violations should be taken into account
Consciousness (clear consciousness, stunning, coma of different degrees).
For example, the so-called «Symptom glasses» (under the eyes are formed
bruises in the form of glasses) indicates a fracture of the base of the skull in
Front cranial jam. But doctors should show «Hematomic
alertness». Brightly demonstration, immediately appeared «symptom
Points» may exist without a fracture, but to become the result
descending hematoma from the frontal area.
Alexander Sergeevich Pushkin in 1830 wrote an excellent fairy tale «O
Pop and worker his bald». If you remember only small
a fragment where the final of the calculation between the Pop and Bald, then here
We obviously, we can observe all the seriousness of the injury,
brain and its consequences.
«Poor pop substituted forehead: from the first tap jumped pop to the ceiling;
From the second tick, the pop language lost, and the mind was bounced from the third cloth
old man». Here in all its glory appears the clinical picture
Injuries. There was the first direct contact, and as a result
short-term, but overly applied forces man jumped from
pain reaction. The second click caused a violation of speech («Loose language»),
But the third blow «elder» - Amnesia has come, possibly -
Violation of consciousness (stunning, stupor, coma) leads to violation
Speech («Literary Okrochka», Matching or complete absence of speech). At
Amnesia is a violation of memory (a person cannot memorize,
save, reproduce). In different cases, the victim does not remember,
What happened during the Time CMT does not remember what was after the exit from
the state of disturbing consciousness does not remember that it was before injury
Do not perceive information at all.
As can be seen, head injury is always serious. Therefore, each
Must know and be able to provide the first assistance to the victim. At all
Caps of severe acceleracy injury need to do radiographs
the cervical spine to eliminate additional and
Perhaps concomitant injury (fractures, fracture-dislocations).
Normalization of changes occurs in terms of 1-14 days, and
Ultrastructural changes in the nervous system can be observed in
limits of 1-4 months and be the source of post-traumatic syndromes
Traumatic Brain Disease.
Lie and no nails!
Further treatment appoints a doctor. Need strict bed
For up to 1 week. Strict bed mode is the basis of the foundation
Treatment, «trunk», on which «hang out» Medical preparations.
Shook around the chambers there and here, engage in nonsense, play cards and
Domino with neighbors, no one should not talk at all.
The victim should behave quietly, like a mouse. Excessive activity,
Reading newspapers, magazines, TV show, especially sports
(football, boxing) - only in harm. All loads are not shown, but
contraindicated. Reception of drugs. After
extracts recommended restriction of physical, mental loads in
within a month.
The minimum deadlines for inpatient treatment in the acute period and total duration are as follows:
- when concussing the brain - at least 2 weeks, temporary disability is at least 4-5 weeks;
- when the brain injury is an easy degree - 3-4 weeks and 1.5-2 months;
- when injected with a severe brain duration up to 2-3 months and more.
According to modern and generally accepted classification, concussion
brain refers to gravity to mild chmt. but
The question of the outcome of the concussion or injury of the brain is decided not earlier
than 3 months after injury. This is due to the fact that
The process is very dynamic and in the post-traumatic period one form
can go to another, qualitatively heavier and serve
The basis for determining the resistance of disobey. therefore
attitude to «Easy» injury should be very serious.
Memo it turned out next
It is necessary to find out the circumstances of the injury in the patient (if he
in consciousness) or eyewitnesses. It is necessary to act like this:
- The patient needs to be put in a horizontal position, unbutton
Collar, weaken the belt, evaluate the severity of the state, pulse, frequency
- Free upper respiratory tract from blood, mucus, foreign
bodies, broken teeth, prostheses using an index finger,
wrapped with wet bandage marks.
- Make artificial fluid «mouth to mouth» or «Nose from mouth». With massive bleeding from wound heads need
stop bleeding by pressing a bleeding vessel on
Double term of bleeding time (8-10 minutes), impose
Soft bandage dressing, call the car «Ambulance» for
Transportation to hospital.
- When eye damage, a sterile bandage is superimposed (you can
Take advantage of a cloth from clean and swallowed sheets, shirts).
Wash damaged eye should not. Exception is made
Chemical eye burns requiring abundant watering with water.
- When bleeding from the ear, you need to lay a hole with a piece of cotton wool,
Bandage or Marley (enter the tampon is deeply impossible due to danger
infection). With a fracture of the nose bones of the patient laid with
raised headboard, apply a bubble with ice or
Slices of ice placed in cellophane package. Fractures of nose bones
always accompanied by bleeding. In this case, strips are introduced into the nose
gauze, bandage moistened with 3% hydrogen peroxide solution or
impregnated with vaseline or any other oil. If the victim B
consciousness, you need to ask him to spit blood, and not to climb, so
How can Vomot possible.
- Lower jaw fractures are almost always accompanied by gaps
mucous. Rinsing the mouth with a weak solution of permanganate
potassium (manganese). Any food is prohibited before entering the hospital.
- Small abrasions, surface wounds are treated with alcohol
iodine solution or diamond green solution (green). Can
use sterile napkins of an individual dressing package and
- The patient with a combined cranial injury should be
transport on hard stretchers by fixing the head on the board and
neck with a roller or inflatable circle. Head must
be turned to the side to avoid the opportunity to choke.
What can I do: Remove bone fragments, foreign bodies from wounds,
to go out dislocations or fractures, deeply tampony,
bad or insufficiently clean upper respiratory tract.