It is unlikely that anyone can boast that he has never received bruises: the lucky ones can be counted on the fingers of one hand.
But few can say for sure what a bruise is and how it differs from a fracture.
A bruise is a traumatic damage to the tissues of an organ or system, often of a mechanical origin, not accompanied by a violation of their integrity.
If a limb bruise is observed, this is unpleasant, but not dangerous. It is a completely different matter if head damage is received. They are very dangerous. By themselves, head bruises are not much different from other bruises: the soft tissues of the head and the periosteum of the bones of the skull suffer. The main danger lies in the high risk of getting brain damage. Brain injuries are fraught with the development of severe neurological deficit and even death.
For this reason, you need to know what a brain contusion is, what are its manifestations and what needs to be done before going to a doctor.
Head injury: first aid
A person who has received a head injury should assume that any head injury is potentially dangerous. Therefore, if neurological or other symptoms are observed, you should not risk your health. The task in this case is to maintain the normal functional state of the body until the ambulance arrives.
More often it is a relatively mild injury with the formation of a bruise or "bump" on the head. In such a situation, the main thing is to remove the pain syndrome that accompanies the bruise. To achieve this, you need to do this:
• Bruising pain is caused by the formation of a hematoma and irritation of nerve endings, so the first thing to do is to stop bleeding from the destroyed capillaries. Ice is great for these purposes. Direct exposure to cold on the skin is not worth it: you can get frostbite. Wrap crushed ice in gauze or a thin cloth, then apply cold to the damaged area for 1-3 minutes. At the end of the procedure, the pain syndrome should become less pronounced. If this does not help, it is worth repeating the procedure (and so on for 1-2 hours with an interval of 15-20 minutes). If there was no ice at hand, you can find an alternative: frozen convenience foods or poultry, cold water.
• Just in case, it is recommended to stop any activity and listen to your own feelings. Dizziness, nausea, visual disturbances, fainting, confusion are just some of the alarming signals. If at least one is present, the patient or other persons must urgently call an ambulance team.
In order for first aid to have an effect, measures should be taken within the first 30-60 minutes.
Much more complicated is the situation with brain injuries. With a brain injury, an ambulance call is required. Attempts to get rid of the injury on your own are doomed to failure in advance. As a rule, with brain contusion, blurred consciousness or its absence is observed. In this case, the burden of first aid falls on others. What to do:
• Lay the patient on his back.
• Turn your head to the side (this will prevent the penetration of vomit into the respiratory tract and the tongue toppling over).
• If vomiting has been observed, the remnants of the vomit must be removed.
• A patient who is conscious should never be brought upright. It is important that he lies on his back or side before the ambulance arrives.
Also, do not rely on your own medical knowledge. Distinguish brain injury from concussion is possible only according to research results. At first glance, this is not obvious even to experienced professionals.
Brain contusion: how to determine it
It is quite difficult to independently determine a brain contusion. Symptoms are blurred and may also be present with concussion. Some conclusions can still be made.
To determine this injury, you must proceed from three important factors:
• The presence or absence of neurological symptoms.
• The functional state of organs and systems.
• States of consciousness.
Depending on the strength of the bruise and the location of the damage, the degree of disturbance on the part of consciousness is different.
In medical practice, there are 7 degrees of impaired consciousness.
1) Consciousness is clear. A person perceives the environment adequately (oneself, others). Spatial and temporal orientation saved. Reflex to pain stimuli is normal.
2) Stun (to a moderate degree). Identity is saved. The perception of verbal commands is slow. General inhibition. Temporal and spatial orientation is slightly reduced. Reflex to pain too.
3) Stun (deep). Self-awareness is broken. The victim gives answers in monosyllabic format. Orientation in space and time is broken.
4) Sopor. A minimal response to external verbal stimuli is maintained. A pain reflex is present.
5) Coma (to a moderate degree). The response to the pain stimulus is preserved. There is practically no reaction to all other stimuli from the outside.
6) Coma (deep). There is no reaction to pain. There are respiratory and cardiac abnormalities.
7) Coma (terminal stage). Accompanied by severe violations of cardiac activity, respiration.
The functional state of organs and systems is assessed by similar characteristics.. To assess their condition, you need:
• Measure pressure.
• To measure the temperature.
• Determine the number of heart contractions.
• Determine the number of respiratory movements.
Results are defined as follows:
1) Norm (no violations):
• Pressure - within 140/90.
• Temperature - 36-37 degrees.
• The number of heart contractions is 65-95 beats.
• Number of respiratory movements: 10-17.
2) Minor violations:
• Mild hypertension (up to 180 / 100-110).
• 37-38 degrees.
• Reduced heart rate (bradycardia) - 50-59 beats. Possible tachycardia up to 100 strokes.
• The number of respiratory movements is 19-29.
3) Violations of a pronounced degree.
• Bradycardia (119 strokes).
• Breathing - less than 11 breaths or more than 30.
• Temperature - up to 39 degrees.
4) With gross and critical violations, the body temperature rises to 39.5-40 degrees, there is a deep respiratory depression. The pressure rises sharply. In critical condition, falls below 60 mm.
Neurological disorders are determined by:
• Reactions of pupils to light.
• The presence of seizures.
Even the most minor violations on the part of the pupils are an alarming sign, as well as cramps.
Thus, the symptoms include:
• Impairment of consciousness of varying degrees.
• Violations of organs and systems.
• Neurological deficit.
In addition, headache, dizziness, nausea, vomiting, visual impairment, and speech are possible.
Head injury: when you need to see a doctor
You should consult a doctor in all cases when there is reason to suspect not just a head injury, but a brain injury. This is axiomatic. Otherwise, the risk of death or at least severe disability is high. You should not neglect a visit to a doctor even with a simple bruise of the head (it is always better to play it safe: careful attention to your health is a recognized practice in the whole civilized world)
In the vast majority of cases, the diagnosis of brain contusion consists in evaluating the above criteria. Computed tomography is recognized as the most informative method, but in view of the fact that computed tomographs are currently not installed everywhere, MRI is also used.
Brain injury: how it is treated, how and for how long
Treatment of brain injuries is carried out exclusively in a hospital (in the neurosurgical department). This is extremely severe damage. Depending on the severity of the damage, doctors can resort to both conservative and surgical treatment.
The specific treatment strategy depends on the severity of the injury.
Conservative therapy includes:
• Measures to normalize breathing. For these purposes, an artificial lung ventilation apparatus is used. The goal of respiratory therapy is to normalize the concentration of oxygen in the blood.
• Intravenous infusion of saline. It is the main method of conservative treatment. With a brain injury, there is a high risk of developing diabetes insipidus (with damage to the pituitary gland and / or hypothalamus), followed by the loss of a huge amount of fluid. In addition, fluid is lost with vomiting, etc. The task is to restore the volume of blood circulating in the body.
• Measures to normalize intracranial pressure. In conditions of constant intravenous infusions, it is not easy to achieve a balance between the infused fluid and the fluid that flows out. With an excess of water in the body, intracranial pressure increases. To reduce it, diuretics (diuretics) are used.
• Measures to protect healthy brain cells. Glucocorticoid drugs, calcium channel blockers (Diltiazem, Verapamil), and barbiturate-based drugs are prescribed. These are very serious drugs. Their independent use is unacceptable
Surgical treatment is performed only according to indications, the circle of which is clearly defined:
• The development of cerebral edema.
• Deterioration of the work of organ and systems, further aggravation of the state of consciousness.
• Extensive brain damage. It implies a crush of brain tissue in a volume of more than 20 cubic centimeters.
In all other cases, conservative therapy is carried out aimed at:
A) Maintaining the normal functioning of the body.
B) Elimination of swelling of brain tissue.
C) Maintaining the regenerative process of brain tissue.
The duration of treatment is different and is determined in the range from 10 to 60 days, not counting the course of rehabilitation. The rehabilitation course lasts from 2 to 6 months.
Thus, a bruise of the head itself does not pose a great danger, where its possible consequences are much more dangerous, among which is a bruise of the brain. It is difficult to independently determine the presence of a brain injury in yourself, and procrastination is dangerous. If there are disturbing symptoms, you should not hesitate to call an ambulance. In other cases, first aid and pain relief are sufficient.
