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Closed brain injuries include concussion (commotio cerebri), contusion (contusio cerebri), compression of the brain (compressio cerebri), often due to fractures of the bones of the arch or base of the skull and traumatic intracranial hemorrhage.
Concussion Clinically, the symptoms of concussion can be divided into three periods: the first is an unconscious state; the second is motor inhibition; the third is neurotic phenomena. The unconscious state lasts, depending on the severity of the injury, from several minutes to several days. The duration of loss of consciousness distinguishes 3 degrees of concussion: 1) mild — cases with short-term impaired consciousness and vomiting; the patient usually recovers quickly; 2) moderate — cases with prolonged loss of consciousness (several hours) and slowing of the pulse; upon the return of consciousness, there is a more or less prolonged retrograde amnesia (patients do not remember the events preceding the injury) .3) severe - accompanied by a deep and prolonged coma, impaired sphincter, decreased or absent reflexes. In the second period, the patient is lethargic, spontaneous, depressed mood. In the third period, neurotic phenomena are expressed - patients are emotionally unstable, fatigue, decreased performance, poor sleep, memory impairment, severity of vasomotor symptoms are noted laziness (sweating, coldness, lability of cardiac activity).
A bruise, or concussion, of the brain, in contrast to a concussion, in which only cerebral symptoms are noted, is accompanied by focal symptoms. Possible speech disturbances, paresis, loss of sensitivity. Along with cortical disorders, there may be symptoms indicating damage to the extrapyramidal system.
With lesions in the region of the anterior cranial fossa, bruising often occurs in the area of the skin of the eyelids - “glasses,” a lesion of a number of cranial nerves is also characteristic.
The facial, vestibule-cochlear and abducent nerves are especially often affected.
Compression of the substance of the brain is caused by bone fragments of the skull, but more often hematomas formed due to intracranial bleeding.
Bleeding with a closed skull injury is divided into epidural, subdural, subarachnoid, intracerebral, or parenchymal, and intraventricular.
Of the greatest importance among these hemorrhages are epidural, subdural and subarachnoid.
Open injuries of the skull are divided into penetrating and non-penetrating.
More often used 40% glucose solution - 20-40 ml intravenously, 10% sodium chloride solution - 10 ml intravenously, 25% magnesium sulfate solution - 10 ml intramuscularly or intravenously, 10% calcium gluconate solution - 10 ml intramuscularly or intravenously. In addition, it is advisable to prescribe mannitol or urea, 0.5-1 g per 1 kg of body weight. A 10% or 20% solution, aseptically prepared before use on an isotonic sodium chloride solution (0.9%) or 5-10% glucose solution, is administered intravenously.
Powerful dehydration is also achieved by the introduction of diuretic drugs (dichlothiazide — hypothiazide, lasix).
If motor anxiety accrues and is not a symptom of compression of the brain, then sedatives are necessary. The most commonly used are derivatives of barbituric acid (phenobarbital 0.1-0.2 mg 1-2 times a day, barbamil 0.1-0.2 mg 1-2 times a day).
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- Brain injuries
A brain injury occurs when a head is struck or a penetrating wound occurs in which brain function is impaired. Manifestations of brain injury can be small, moderate or severe, depending on the severity of the brain injury. Mild manifestations of trauma can consist of a slight change in consciousness, while severe trauma can result in loss of consciousness and
- Brain injuries
Closed brain injuries include concussion (commotio cerebri), contusion (contusio cerebri), compression of the brain (compressio cerebri), often due to fractures of the bones of the arch or base of the skull and traumatic intracranial hemorrhage. A concussion occurs when an object hits a head, when a head hits a solid object, or when
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- Abstract. Brain circulation and brain response to hypoxia, 2012
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- BRAIN TUMORS
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