What people write about severe trauma. Traumatic brain injury (TBI), head injuries: causes, types, signs, help, treatment. Fracture of the base and vault of the skull

Japanese physicists have discovered a giant cavity in the Cheops pyramid using muon scanning. They talked about the discovery in the magazine Nature .

The Pyramid of Cheops was built about 4,500 years ago and is the largest of the Egyptian pyramids. Its height is 139 m. Unlike most pyramids of that time, which were built over tombs, the Cheops pyramid contains several rooms. The Pharaoh's Chambers, the Queen's Chambers and the Great Gallery were discovered in the 9th century and studied in detail in the 19th century.

However, the question of whether there are other rooms in the pyramid and whether the tomb of the pharaoh is located in one of them still occupies scientists and enthusiasts.

Nature/nature.com

The scan was carried out as part of the project ScanPyramids, launched in October 2015. The goal of the scientists was to discover rooms inside the pyramids of Cheops and Khafre in Giza, as well as the Bent and Pink pyramids in Dahshur. The project uses infrared thermography, muon radiography and 3D reconstruction.

Cosmic rays coming from the Sun and beyond solar system, are mostly made up of protons. When a high-energy particle enters the Earth's atmosphere, it produces a flurry of particles, mostly pions and muons, which themselves produce other particles. Negatively charged muons appear for millionths of a second, moving at almost the speed of light and causing no harm to objects on the surface of the Earth.

So, according to statistics, several hundred muons fly through a person’s head per minute.

However, when flying through dense objects, muons lose part of their energy, so with the help of special sensors, physicists have already learned to find secret voids behind stone walls, inside volcanoes, in the Mayan and Egyptian pyramids.

“If you're looking for voids, you need to look for an excess of muons in a certain direction,” explains Arturo Menhaza-Roja, a physicist at the National Autonomous University in Mexico City who uses the method to study the Mexican pyramids. -

"Tracking muons allows us to localize and estimate the shape of cavities."

“The beautiful thing is that muons lose enough energy to be detected, but not so much that they are completely absorbed by the target. “This is truly a fabulous gift from nature,” adds particle physicist Roy Schwitters of the University of Austin, who was not involved in the project. “Scientists really have found a gold mine.”

Japanese physicists from Nagoya University placed muon detectors in the Queen's chambers - the stone absorbs these particles, and if there is a cavity near the sensor, it will pick up more muons. Two more groups of researchers joined in checking the data obtained.

All three teams agreed that the results indicated the presence of a large room above the Grand Gallery.

ScanPyramids

The length of the discovered cavity is 30 meters. It can be located either parallel to the ground or at an angle, the researchers note. It may actually be divided into several smaller rooms. The purpose of the room is not yet known, but its size indicates that it clearly played a significant role in the tomb of the pharaoh.

“The chances of discovering a secret tomb are zero,”

- says Egyptologist Aidan Dodson. However, experts hope that the find will allow us to learn much more about how the pyramid was built.

Perhaps, Dodson suggests, the ancient Egyptian builders wanted to reduce the load of masonry on the ceiling of the Great Gallery with the help of the room. Similar solutions were used, for example, in the pyramid of Pharaoh Snefru, the father of Cheops.

But geologist and engineer Colin Reeder believes that the new room was too far from the Great Gallery to have such a purpose.

According to his assumption, it can lead to another room, just as the Great Gallery leads to the chambers of the Pharaoh.

A third theory is put forward by Egyptologist Bob Brier. He had previously suggested that the Great Gallery was part of the counterweight system used by the pyramid builders to move granite blocks when building the Pharaoh's chambers. It is quite possible that the new premises had a similar purpose, he believes.

Researchers discovered two previously unknown voids in the Cheops pyramid. One of them is located in the northern part of the pyramid, the other in the northeast. Both resemble corridors. It is not yet possible to say whether they are related.

Traumatic brain injury (TBI), among other injuries to various parts of the body, accounts for up to 50% of all traumatic injuries. TBI is often combined with other injuries: chest, abdomen, bones of the shoulder girdle, pelvis and lower limbs. In most cases, head injuries are sustained by young people (usually males) who are at a certain stage alcohol intoxication, which noticeably aggravates the condition, and foolish children who do not sense danger well and cannot calculate their strength in some amusements. A large share of TBI occurs in road traffic accidents, the number of which is only increasing every year, because many (especially young people) get behind the wheel without sufficient driving experience and internal discipline.

Every department can be at risk

Traumatic brain injury can affect any structure (or several simultaneously) of the central nervous system(CNS):

The most vulnerable and susceptible to injury main component of the central nervous system is gray matter of the cerebral cortex, concentrated not only in the cortex cerebral hemispheres, but also in many other departments brain(GM);
White matter, located mainly deep in the brain;
Nerves piercing the bones of the skull (cranial or cranial) - sensitive, transmitting impulses from the senses to the center, motor, responsible for normal muscle activity, and mixed, having a dual function;
Each of them blood vessels , nourishing the brain;
Ventricular walls GM;
Pathways ensuring the movement of cerebrospinal fluid.

Simultaneous injury to different regions of the central nervous system significantly complicates the situation. Severe traumatic brain injury changes the strict structure of the central nervous system, creates conditions for edema and swelling of the brain, which leads to disruption of the functional capabilities of the brain at all levels. Similar changes, causing serious disorders important brain functions, affect the functioning of other organs and systems that ensure the normal functioning of the body, for example, systems such as the respiratory and cardiovascular systems often experience suffering. In this situation there is always a danger of complications in the first minutes and hours after receiving damage, as well as the development serious consequences, distant in time.

With TBI, you should always keep in mind that the brain can be injured not only at the site of the impact itself. No less dangerous is the impact of counter-impact, which can cause even more harm than the force of the impact. In addition, the central nervous system may experience suffering caused by hydrodynamic fluctuations (liquor push) and a negative effect on the processes of hard tissues. meninges.

Open and closed TBI - the most popular classification

Probably all of us have heard more than once that when it comes to brain injuries, there is often a clarification: it is open or closed. What's the difference?

Invisible to the eye

Closed head injury(with it the skin and underlying tissues remain intact) includes:

The most favorable option is;
A more complex option than just a concussion is a brain contusion;
A very serious form of TBI is compression resulting from: epidural when blood fills the area between the bone and the most accessible one - the outer (dura) meninges, subdural(blood accumulation occurs under the dura mater), intracerebral, intraventricular.

If cracks in the cranial vault or fracture of its base are not accompanied by bleeding wounds and abrasions that damage the skin and tissue, then such TBIs are also classified as closed craniocerebral injuries, although conditionally.

What's inside if it's already scary outside?

An open craniocerebral injury, which has its main signs of a violation of the integrity of the soft tissues of the head, skull bones and dura mater, is considered to be:

Fracture of the vault and base of the skull with soft tissue damage;
Fracture of the base of the skull with damage to local blood vessels, which entails the flow of blood during a blow from the nostrils or from the auricle.

Open TBIs are usually divided into gunshot and non-gunshot, and, in addition, into:

Non-penetrating lesions of soft tissues (meaning muscles, periosteum, aponeurosis), leaving the outer (dura) meninges intact;
Penetrating wounds with disruption of the integrity of the dura mater.

Video: about the consequences of closed TBI – “Live Healthy” program

The division is based on other parameters

In addition to dividing brain injuries into open and closed, penetrating and non-penetrating, they are also classified according to other criteria, for example, TBI is classified according to severity:

ABOUT easy brain injury is referred to as concussion and bruises of the brain;
Average the degree of damage is diagnosed in cases of brain contusions that, taking into account all the disorders, can no longer be attributed to mild degree, and they still do not reach the point of severe traumatic brain injury;
TO severe degrees include severe contusion with diffuse axonal damage and compression of the brain, accompanied by profound neurological disorders and numerous disruptions in the functioning of other vital systems.

Or according to the characteristics of lesions of the central nervous system structures, which allows us to distinguish 3 types:

Focal damage that mainly occurs against the background of a concussion (impact-counter-impact);
Diffuse(acceleration-deceleration injury);
Combined lesions (multiple injuries to the brain, blood vessels, liquor pathways, etc.).

Considering the cause-and-effect relationships of head trauma, TBI is described as follows:

Traumatic brain injuries that occur against the background of complete health of the central nervous system, that is, a blow to the head is not preceded by brain pathology, are called primary;
ABOUT secondary TBI is discussed when they become a consequence of other cerebral disorders (for example, the patient fell during an epileptic attack and hit his head).

In addition, when describing brain injury, experts focus on such points as, for example:

Only the central nervous system, namely the brain, was damaged: then the injury is called isolated;
TBI is considered combined when, along with damage to the brain, other parts of the body (internal organs, skeletal bones) were damaged;
Injuries caused by the simultaneous damaging influence of various unfavorable factors: mechanical impact, high temperatures, chemicals, etc., as a rule, are the cause combined option.

And finally: there is always a first time for something. So it is with a TBI - it can be the first and the last, or it can become almost habitual if it is followed by a second, third, fourth, and so on. Is it worth reminding that the head does not like blows and even with a mild concussion from a head injury one can expect complications and consequences that are distant in time, not to mention a severe traumatic brain injury?

More favorable options

The mildest type of head injury is a concussion. the symptoms of which even non-medics can recognize:

As a rule, having hit his head (or received an external blow), the patient immediately loses consciousness;
More often, loss of consciousness is followed by a state of stupefaction, less often psychomotor agitation can be observed;
Headache, nausea and vomiting are usually perceived as characteristic symptoms GM concussions;
After an injury, signs of ill health such as pale skin, impaired heart rate(tachy- or bradycardia);
In other cases, there is a memory impairment of the retrograde amnesia type - the person is unable to remember the circumstances that preceded the injury.

A more severe TBI is considered to be a bruise of the brain, or, as doctors call it, a concussion. In case of a bruise, general cerebral disorders (repeated vomiting, severe headache, impaired consciousness) and local lesions (paresis) are combined. How pronounced the clinical picture is, which manifestations occupy a leading position - all this depends on the region in which the lesions are located and the scale of the damage.

As evidenced by the trickle of blood flowing from the ear...

Signs of fractures of the base of the skull also appear depending on the area in which the integrity of the cranial bones is compromised:

A stream of blood flowing from the ears and nose indicates a fracture of the anterior cranial fossa (AC);
When not only the anterior but also the middle CN is damaged, cerebrospinal fluid leaks from the nostrils and ear, the person does not react to odors, and ceases to hear;
Bleeding in the periorbital region gives such a vivid manifestation that does not raise doubts about the diagnosis as a “symptom of glasses”.

As for the formation of hematomas, they occur due to injury to arteries, veins or sinuses and lead to compression of the brain. These are always severe traumatic brain injuries that require emergency neurosurgical surgery, otherwise the rapid deterioration of the victim’s condition may leave him no chance of life.

Epidural hematoma is formed as a result of injury to one of the branches (or several) of the middle meningeal artery, which supplies the dura mater. In this case, the blood mass accumulates between the skull bone and the dura mater.

Symptoms of the formation of an epidural hematoma develop quite rapidly and manifest themselves:

Unbearable pain in the head;
Constant nausea and repeated vomiting.
The patient's lethargy, sometimes turning into excitement, and then into a coma.

This pathology is also characterized by the appearance meningeal symptoms and signs of focal disorders (paresis - mono- and hemi-, loss of sensitivity on one side of the body, partial blindness such as homonymous hemianopia with loss of certain halves of the visual fields).

Subdural hematoma is formed against the background of injury to the venous vessels and the time of its development is significantly longer than that of an epidural hematoma: at first it clinically resembles a concussion and lasts up to 72 hours, then the patient’s condition seems to improve and within about 2.5 weeks he believes that he is going to amendment. After this period, against the background of general (imaginary) well-being, the patient’s condition sharply worsens, and pronounced symptoms of general cerebral and local disorders appear.

Intracerebral hematoma- a rather rare phenomenon that occurs mainly in elderly patients, their favorite place of localization is the middle-class swimming pool cerebral artery. Symptoms tend to progress (general cerebral disorders appear first, then local disorders increase).

Post-traumatic refers to serious complications of severe traumatic brain injury. It can be recognized by complaints of intense headache(until consciousness leaves the person), a rapid disorder of consciousness and the onset of a coma, when the victim no longer complains. These symptoms are also quickly joined by signs of dislocation (displacement of structures) of the brain stem and cardiovascular pathology. If at this moment a lumbar puncture is performed, then in the cerebrospinal fluid you can see a huge amount of fresh red blood cells - erythrocytes. By the way, this can also be detected visually - the cerebrospinal fluid will contain blood impurities, and therefore will acquire a reddish tint.

How to help in the first minutes

First aid is often provided by people who, by chance, find themselves close to the victim. And they are not always health workers. In case of TBI, however, it should be understood that loss of consciousness can continue for a very long time. a short time and therefore not fixed. However, in any case, a concussion, as a complication of any (even seemingly mild) head injury, should always be kept in mind and, taking this into account, help the patient.

If a person who has received a TBI does not come to his senses for a long time, he needs to be turned over on his stomach and his head tilted down. This must be done in order to prevent the entry of vomit or blood (in case of injuries oral cavity) into the respiratory tract, which often happens in unconscious(absence of cough and swallowing reflexes).

If the patient has signs of impairment respiratory function(there is no breathing), measures should be taken to restore patency respiratory tract and before the ambulance arrives, provide simple artificial ventilation lungs (“mouth to mouth”, “mouth to nose”).

If the victim is bleeding, it is stopped with elastic bandage(a soft lining on the wound and a tight bandage), and when the victim is taken to the hospital, the surgeon will suture the wound. It’s worse when there is a suspicion of intracranial bleeding, because its complication is most likely hemorrhage and hematoma, and this is already a surgical treatment.

Due to the fact that a traumatic brain injury can occur in any place that is not necessarily within walking distance of a hospital, I would like to introduce the reader to other methods of primary diagnosis and first aid. In addition, among the witnesses trying to help the patient, there may be people with certain knowledge in medicine (nurse, paramedic, midwife). AND here's what they should do:

The first step is to assess the level of consciousness in order to determine the patient’s further condition (improvement or deterioration) based on the degree of response, and at the same time – psychomotor status, severity pain in the head (not excluding other parts of the body), the presence of speech and swallowing disorders;
If blood or cerebrospinal fluid leaks from the nostrils or ears suggest a fracture of the base of the skull;
It is very important to pay attention to the victim’s pupils (dilated? different sizes? How do they react to light? strabismus?) and report the results of your observations to the doctor to the arriving ambulance team;
Routine activities such as color determination should not be ignored skin, measuring heart rate, breathing rate, body temperature and blood pressure(if possible).

With TBI, any part of the brain can suffer, and the severity of one or another neurological symptoms depends on the location of the lesion, for example:

Damaged area of the cerebral cortex big brain will make any movement impossible;
If the sensitive cortex is damaged, sensitivity will be lost (all types);
Cortical damage frontal lobes will lead to a disorder of higher mental activity;
The occipital lobes will no longer control vision if their cortex is damaged;
Injuries to the cortex of the parietal lobes will create problems with speech, hearing and memory.

In addition, we should not forget that cranial nerves can also be injured and give symptoms depending on which area is affected. And also keep in mind fractures and dislocations of the lower jaw, which, in the absence of consciousness, press the tongue against back wall pharynx, thereby creating a barrier to the air flowing into the trachea and then into the lungs. To restore the passage of air, it is necessary to extend lower jaw forward, placing your fingers behind her corners. In addition, the injury can also be combined, that is, with a TBI, other organs can be damaged at the same time, therefore, a person who has received a head injury and is in an unconscious state must be treated with extreme care and caution.

And one more important point when providing first aid: you need to remember about the complications of TBI, even if at first glance it seemed mild. Bleeding into the cranial cavity or increasing cerebral edema increases intracranial pressure and can lead to compression of the GM(loss of consciousness, tachycardia, increased body temperature) and brain irritation(loss of consciousness, psychomotor agitation, inappropriate behavior, obscene language). However, let's hope that by that time the ambulance will have already arrived at the scene and quickly taken the victim to the hospital, where he will receive proper treatment.

Video: first aid for TBI

Treatment is exclusively in a hospital setting!

Treatment of TBI of any severity is carried out only in a hospital setting, because loss of consciousness immediately after receiving a TBI, although it reaches a certain depth, does not in any way indicate the real condition of the patient. The patient can prove that he feels fine and can be treated at home, however, given the risk of complications, he is provided with strict bed rest(from one week to a month). It should be noted that even a concussion of the brain, having a favorable prognosis, in the case of large-scale damage to parts of the brain can leave neurological symptoms for life and limit the patient’s ability to choose a profession and further ability to work.

Treatment of TBI is generally conservative unless other measures are provided ( surgery in the presence of signs of brain compression and hematoma formation), and symptomatic:

The gag reflex and psychomotor agitation are suppressed haloperidol;
Cerebral edema is relieved with dehydrating medications ( mannitol, furosemide, magnesium, concentrated glucose solution and etc.);
Long-term use of dehydration medications requires the addition of potassium supplements to the prescription list ( panangin, potassium chloride, potassium orotate);
For severe pain effects, indicated analgesics, and sedatives and tranquilizers(the patient should rest more);
They have a good effect antihistamines , drugs that strengthen the walls of blood vessels (calcium supplements, ascorrutine, vitamin C), improving rheological properties blood, ensuring water-electrolyte balance and acid-base balance;
If necessary, the patient is given medications, which contribute to the normalization of the cardiovascular system;
Vitamin therapy is prescribed when the acute period is behind us - it is more indicated at the stage of recovery after injury.

The Hard Way – Brain Injuries in Newborns

It is not uncommon for newborns to be injured when passing through birth canal or in the case of the use of obstetric instruments and certain obstetric techniques. Unfortunately, such injuries are not always avoided " little blood” of the baby and “slight fright” of the parents, sometimes they leave consequences that become a big problem for the rest of their lives.

At the very first examination of the baby, the doctor pays attention to the following points that can help determine the general condition of the newborn:

Is the baby capable of sucking and swallowing?
Is his tone and tendon reflexes reduced?
Is there any damage to the soft tissues of the head;
What condition is the large fontanel in?

In newborns who received injuries during passage through the birth canal (or various obstetric injuries), complications such as:

Hemorrhages (in the brain, its ventricles, under the membranes of the brain - in connection with which subarachnoid, subdural, epidural hemorrhage is distinguished);
Hematomas;
Hemorrhagic permeation of the brain substance;
CNS lesions caused by contusion.

Symptoms of birth brain injury mainly come from the functional immaturity of the brain and reflex activity nervous system, where consciousness is considered a very significant criterion for determining disorders. However, it should be borne in mind that there are significant differences between changes in consciousness in adults and babies who have just seen the light, therefore, in newborns, for a similar purpose, it is customary to study the behavioral states characteristic of children in the first hours and days of life. How does a neonatologist find out about problems in the brain of such a person? small child? Pathological signs of impaired consciousness in newborns include:

Constant sleep (lethargy), when the baby can only be awakened by severe pain caused to him;
Stunned state – the child does not wake up when exposed to pain, but reacts by changing his facial expressions:
Stupor, which is characterized by a minimum of the baby’s reactions to stimuli;
A comatose state where there are no reactions to pain.

It should be noted that to determine the condition of a newborn who was injured at birth, there is a list of various syndromes that the doctor focuses on:

Hyperexcitability syndrome (the child does not sleep, constantly writhes, grunts and screams);
Convulsive syndrome (convulsions themselves or other manifestations that may correspond to this syndrome - apnea attacks, for example);
Meningeal syndrome ( increased sensitivity to stimuli, reaction to percussion of the head);
(anxiety, large head, increased venous pattern, bulging fontanel, constant regurgitation).

Obviously - diagnostics pathological conditions brain caused by birth trauma is quite complex, which is explained by immaturity brain structures in children during the first hours and days of life.

Medicine can’t do everything...

Treatment of birth brain injuries and care of a newborn require maximum attention and responsibility. A severe traumatic brain injury in a child, received during childbirth, requires the baby to stay in specialized clinic or department (with the baby placed in an incubator).

Unfortunately, birth injuries to the brain are not always without complications and consequences. In other cases, the intensive measures taken save the child’s life, but cannot ensure his full health. Leading to irreversible changes, such injuries leave a mark that can significantly negatively affect the functioning of the brain and the entire nervous system as a whole, posing a threat not only to the child’s health, but also to his life. Among the most severe consequences birth trauma GM should be noted:

Dropsy of the brain or, as doctors call it -;
Cerebral palsy (CP);
Mental and physical retardation;
Hyperactivity (increased excitability, restlessness, nervousness);
Convulsive syndrome;
Speech impairment;
Diseases internal organs, allergic diseases.

Of course, the list of consequences can be continued... But whether the treatment of birth injury to the brain will cost with conservative measures or will have to resort to neurosurgical operation depends on the nature of the injury received and the depth of the disorders that followed it.

Video: head injuries in children of different ages, Dr. Komarovsky

Complications and consequences of TBI

Although there has already been mention of complications in various sections, there is still a need to touch upon this topic again (in order to understand the seriousness of the situation created by TBI).

Thus, during acute period The patient may face the following troubles:

External and internal bleeding, creating conditions for the formation of hematomas;
Leakage of cerebrospinal fluid (cerebrospinal fluid rhinorrhea) – external and internal, which threatens the development of infectious inflammatory process;
Penetration and accumulation of air in cranium(pneumocephalus);
Hypertension (hydrocephalic) syndrome or – increased intracranial pressure as a result of which disturbances of consciousness, convulsive syndrome, etc. develop;
Suppuration of wound sites, formation of purulent fistulas;
Osteomyelitis;
Meningitis and meningoencephalitis;
GM abscesses;
Bulging (prolapse, prolapse) of the GM.

The main cause of death of the patient in the first week of illness is considered to be cerebral edema and displacement of brain structures.

TBI does not allow either doctors or the patient to calm down for a long time, since even in the later stages it can present a “surprise” in the form of:

Formation of scars, adhesions and, development of hydrops GM and;
Convulsive syndrome with subsequent transformation into, as well as astheno-neurotic or psychoorganic syndrome.

The main cause of death of a patient in the late period is complications caused by purulent infection(pneumonia, meningoencephalitis, etc.).

Among the consequences of TBI, which are quite diverse and numerous, I would like to note the following:

Movement disorders (paralysis) and persistent sensory impairment;
Impaired balance, coordination of movements, changes in gait;
Epilepsy;
Pathology of ENT organs (sinusitis, sinusitis).

Recovery and rehabilitation

If a person who has received a mild concussion in most cases is safely discharged from the hospital and soon remembers his injury only when asked about it, then people who have experienced severe traumatic brain injury face a long and difficult path of rehabilitation in order to restore lost basic skills . Sometimes a person needs to learn to walk, talk, communicate with other people, and take care of himself independently. Any means are good here: physical therapy, massage, all kinds of physiotherapeutic procedures, and manual therapy, and classes with a speech therapist.

Meanwhile, to restore cognitive abilities after a head injury, sessions with a psychotherapist are very useful, who will help you remember everything or most of it, teach you to perceive, remember and reproduce information, and adapt the patient in everyday life and society. Unfortunately, sometimes lost skills never return... Then all that remains is to teach a person to serve himself and contact people close to him to the maximum (as far as intellectual, motor and sensory abilities allow). Of course, such patients receive a disability group and need outside help.

In addition to the listed measures during the rehabilitation period, people with a similar history are prescribed medicines. As a rule, these are vitamins.

Traumatic brain injury is a collective concept that includes damage to the soft tissues of the head, skull bones, brain, and meninges. Distinctive feature is that the entire complex of injuries has a single cause and development mechanism.

One of the features of brain damage is high percent mortality in moderate and severe injuries. Traumatic brain injuries are the main cause of disability among working people among all traumatic injuries. In addition, even after mild injuries, residual effects can form.

Brain damage usually has consequences

Classification of consequences of TBI

Depending on how much time has passed since the traumatic brain injury, the consequences are divided into two groups - early and late. The first include:

coma;
dizziness;
hematomas;
hemorrhages;
addition of infection.

Among the long-term consequences of traumatic brain injuries, the most commonly diagnosed are:

cerebroasthenic syndrome;
sleep disturbance;
chronic headache syndrome;
depressive disorders;
memory impairment, problems concentrating;
violation of certain brain functions - speech, vision, motor activity, sensitivity;
convulsive syndrome;
intracranial hypertension.

Early consequences are those that develop in the first 7-14 days after injury - in the so-called early post-traumatic period. With brain contusions, diffuse axonal damage, and hemorrhages, it increases to ten weeks. The intermediate period is from two months to six months from the moment of receiving a traumatic brain injury. After that it starts long-term period, which lasts up to two years. Disorders of the central nervous system diagnosed later than two years later are not regarded as residual effects of traumatic brain injury.

Treatment

Timely diagnosis and the beginning of treatment for traumatic brain injuries - key moment, which reduces the risk of developing residual effects to a minimum.

Consequently, rehabilitation treatment of a patient with a traumatic brain injury begins in a neurological hospital and continues in outpatient setting. Full recovery is only possible with integrated approach to the treatment process, which should include the following areas:

drug treatment;
physiotherapeutic procedures and physical therapy;
treatment with folk remedies;
psychological help.

A concussion is treated with a complex of measures, starting with medications and ending with psychological help.

Treatment tactics varies depending on how much time has passed since the brain injury and on individual characteristics patient.

Early post-traumatic period

The patient spends the early post-traumatic period in a specialized department under the supervision of specialists. Volume pharmacological drugs determined strictly individually. This takes into account the degree of brain damage, the type of residual effect, the general condition of the patient, his age, and the presence of concomitant pathology. Treatment is aimed at maintaining vital functioning important organs and systems, normalization of acid-base and water-salt balance, correction of blood clotting parameters. In parallel, drugs are prescribed whose task is to help the surviving neurons integrate into the activity of the central nervous system. Doctors mainly use the following groups of drugs:

drugs that reduce intracranial pressure;
vascular drugs;
neuropeptides.

According to indications, painkillers, antibiotics, and hemostatic agents are used.

Drugs that reduce intracranial pressure

After an injury, intracranial pressure may increase, in which case the doctor prescribes drugs that lower it

In a hospital setting, osmotic diuretics are used to reduce intracranial pressure, most often mannitol. It increases the osmotic pressure in the capillaries, resulting in the redistribution of fluid from the tissues into the vessels. Loop diuretics of the furosemide type are prescribed once to reduce the likelihood side effects from application. Diacarb - activates the secretion of sodium by the kidneys, which also leads to a decrease in the volume of circulating fluid. If intracranial hypertension is difficult to treat, in addition to diuretics, glucocorticosteroids are prescribed - dexamethasone, prednisolone, methylprednisolone.

On an outpatient basis, the patient is prescribed Diacarb and glucocorticoids. The dosage and duration of treatment are determined individually, depending on the severity of symptoms.

Vascular drugs

Their main task is to normalize blood flow in the capillary bed and improve blood supply to the lesion. The most commonly prescribed drugs are Cavinton, Bravinton, Vinpocetine, and Ceraxon. With their help, it is possible to reduce the affected area, eliminate or reduce the severity of residual effects.

Neuropeptides

The group of neuropeptides includes Cerebrolysin, Actovegin, Cortexin. These are drugs of animal origin. Their active substance– protein molecules whose mass does not exceed 10 thousand daltons and short amino acid chains. They are able to act as antioxidants, reduce the activity of the inflammatory process, enhance the regeneration of neuronal processes and form new synaptic connections. Externally, this is manifested by a significant improvement in the functioning of the central nervous system. The most commonly prescribed nootropic is piracetam.

Interim period

The vast majority of victims of brain damage spend this period at home. Only patients with severe severe symptoms, requiring the prescription of new groups of drugs or dose adjustments of drugs already taken. As a rule, the same drugs are prescribed as in early period. According to indications, if available convulsive syndrome, sleep disorders and mental disorders, prescribe:

anticonvulsants;
sleeping pills;
antidepressants;
remedies for mood disorders.

In addition, a complex is prescribed general strengthening vitamins and minerals, complete nutrition. As soon as the patient’s condition allows, physical therapy, massage, physiotherapeutic procedures, and exercises aimed at improving cognitive functions are added. Such measures are especially effective in patients with focal symptoms of brain damage. At the same time, they monitor a sufficient level physical activity patient.

Late period

Treatment in the late post-traumatic period is carried out on an outpatient basis. If necessary, the patient consults the attending physician. The drugs are prescribed in tablet form, which greatly simplifies the treatment process. Treatment in a hospital setting is planned and carried out in courses. Their necessity is determined general condition patient and the severity of symptoms that remain after brain damage.

The victim must continue to exercise physical therapy, undergo physiotherapeutic procedures, massage. To stimulate intellectual activity, reading and studying are recommended foreign languages, solving crosswords, solving logic puzzles.

Psychological assistance, auto-training sessions, etc. are actively used nonspecific treatment, whose main task is to help the patient adapt to everyday life and society, to increase his independence and communication skills.

Folk remedies

Treatment with folk remedies can significantly increase the effectiveness of traditional drugs in patients with residual effects after traumatic brain injury.

For cerebroasthenic syndrome, which is accompanied by weakness, fatigue, irritability, it is prescribed alcohol tinctures tonic plants – ginseng, Schisandra chinensis, eleutherococcus. Very good effect give morning rubdowns with a damp towel, which after two to three weeks should be replaced by dousing.

Also used to treat concussion folk remedies, in particular, sedative collection

To eliminate vegetative-vascular manifestations, a sedative preparation is used. It contains valerian, hop cones, elecampane, licorice, thyme and lemon balm in equal proportions. A tablespoon of raw material is poured into a glass of boiling water and left in a thermos overnight. As a result we get daily dose medicine, which is taken in two doses.

An infusion of lavender flowers, rosemary, thyme, rue, hop cones, and fireweed has a sedative and tonic effect. Prepare and take it as in the previous recipe.

Finally

Traumatic brain injury, especially moderate and severe, is difficult to treat. Probability negative consequences increases when therapy is not started in a timely manner or when drugs are prescribed in an incomplete volume. At the same time, adequate therapy and careful compliance with all doctor’s instructions significantly increase the chances of a full recovery. If you have any doubts or questions about healing process– discuss them with your doctor. This will make it possible to get good result in the shortest possible time.