How is a neurosurgeon examined after a head injury?

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The condition of the victim and further treatment depend on the complexity of the injury. Causes of pathology: falls, accidents, physical impact.

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Trauma to the skull and back

Head injury provokes pathologies in the neck area, which leads to complications.

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Scull

TBI leads to impaired brain functionality.

Two types of damage: open and closed.

1. In the first case, a rupture of the skin and a fracture of the skull bones occurs.
2. The second type is characterized by bruise, compression or concussion.

Signs of pathology depend on the complexity of the damage (from dizziness to falling into a coma). After receiving even a minor head injury, you must go to the hospital for diagnostics.

Complications may occur as a result of injury:

• Encephalitis,
• Traumatic meningitis,
• Intracranial hematoma,
• Epilepsy.

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Back

Injuries to the spine are just as dangerous as brain injuries, as complete or partial paralysis of the musculoskeletal system can occur. There are different forms of damage, all of them divided by degree of complexity.

Symptoms of spinal cord injury are similar to signs of brain injury; pain is observed in the spinal region. The injury is most often observed in the cervical region, located next to the head.

The consequence of the pathology will be complete paralysis, which cannot be treated. If injured, the victim must be given first aid for a head injury and taken to a medical facility.

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Common damage

The most common type of head injury is blunt head trauma.

Pathology is observed as a result of a blow with a blunt object or a fall on a hard surface. The damage is either closed or open.

Such an impact on the head area leads to the formation of bruises and abrasions with minor damage, but with a strong blow, complete destruction of the head is possible.

Blunt trauma is the cause of death of the victim. For mild forms of damage, complex treatment is carried out. To eliminate the pathology, conservative and surgical treatment methods can be used.

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Possible echoes

The consequences of traumatic brain injury include:

• Headaches of varying intensity;
• Loss of hearing, smell, vision.;
• Memory loss;
• Paralysis.

Other pathologies may be observed that are caused by disruption of the brain, nervous system or other organs (systems). Patients often experience headaches and epileptic seizures.

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Pain

90% of victims experience constant headaches and dizziness during the first 2-3 weeks. These symptoms are a sign of serious problems in the brain. Pain varies in nature: acute and chronic.

Acute headache and nausea indicate the following pathologies:

• Hematoma: local nature of pain, nausea, vomiting, psychological and neurological disorders;
• Cerebral hemorrhage: head movements provoke an attack of severe pain, fever, epileptic seizures and convulsions are observed;
• Head injury: general symptoms of pathologies in the brain.

As a result of the damage, some victims are diagnosed with chronic headaches. If the discomfort does not disappear 2 months after the injury, then the pain takes on a chronic form. Some people cannot get rid of the pathological condition even after years.

The disease is accompanied by other disorders:

• Noise in ears,
• Dizziness,
• Irritability,
• Weakness.

In the absence of proper treatment, the symptoms only intensify, debilitating the person and weakening his body.

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Epilepsy

Head trauma is one of the causes of epilepsy. But this pathology is observed only in 20% of victims, since the progression of the disease is influenced by several factors.

Epileptic seizures that occur as a result of head trauma are medically called post-traumatic epilepsy after injury. The pathology is characterized by socio-psychological deviations. Treatment is carried out in the form of drug therapy and psychological assistance.

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Rehabilitation

The consequences of injury are eliminated by therapeutic methods, these include medication, physiotherapy and exercise therapy. There are cases when a person loses his sense of smell after suffering a trauma. Some patients, especially those with spinal cord injury, may experience arm paralysis. Rehabilitation for such pathologies takes place with special attention.

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Smell

Losing the sense of smell greatly complicates a person’s life, so the patient tries to regain sensitivity. But you shouldn’t take risks and self-medicate. Traditional methods can help, but lead to serious complications. It's better to trust the specialists.

To restore the sense of smell, medications and physiotherapy procedures are used. Adequate hormonal therapy and a course of B vitamins are recommended. Without treatment, it is difficult to restore the sense of smell.

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Physical activity

Impaired functionality of the limbs is often observed. In addition to drug treatment and other additional methods, the patient will need regular courses of exercise therapy.

The first classes should be performed in the presence of a specialist who will determine the intensity and frequency of the exercises. There is no need to overstrain your muscles. If there is severe pain, it is better to stop performing gymnastics until the patient feels better. Exercise therapy is an effective method of combating limb dysfunction.

You can reduce the risk of complications if you contact a medical professional for help immediately after receiving an injury. There is no need to put off visiting a doctor or neglect treatment.

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First aid

Anyone can find themselves in a situation where there is a person nearby with a head injury. Knowing the rules for providing first aid, you can alleviate his condition and even save his life.

1. Signs of a serious traumatic brain injury include blood or clear fluid (CSF) leaking from the nose or ear and bruising around the eyes. Symptoms may not appear immediately, but may take several hours, so if there is a severe blow to the head, you must call an ambulance immediately.
2. If the victim has lost consciousness, breathing and pulse should be checked. If they are absent, you will need to perform artificial respiration and cardiac massage. If there is a pulse and breathing, the person is placed on his side before the ambulance arrives, so that possible vomiting or a sunken tongue will prevent him from suffocating. You cannot sit him down or lift him to his feet.
3. In case of a closed injury, ice or a cold wet towel should be applied to the site of impact to stop tissue swelling and reduce pain. If there is a bleeding wound, you should lubricate the skin around it with iodine or brilliant green, cover the wound with gauze and carefully bandage your head.
4. It is strictly forbidden to touch or remove fragments of bones, metal or other foreign bodies protruding from the wound, so as not to increase bleeding, damage the tissue even more, or cause infection. A gauze roll is first placed around the wound, and then a bandage is made.
5. The victim can only be transported to the hospital in a supine position.

The hospital conducts an examination, determines the severity of the patient’s condition, and prescribes diagnostic procedures. For open wounds with bone fragments or other foreign bodies, the patient requires urgent surgery.

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Prognosis for traumatic brain injury

Concussion is a predominantly reversible clinical form of injury. In more than 90% of cases of concussion, the outcome of the disease is the recovery of the victim with full restoration of ability to work.

In some patients, after the acute period of concussion, manifestations of post-concussion syndrome are noted: disturbances in cognitive functions, mood, physical well-being and behavior.

After 5-12 months, these symptoms disappear or are significantly smoothed out.

Prognostic assessment in severe traumatic brain injury is carried out using the Glasgow Outcome Scale. A decrease in the total score on the Glasgow scale increases the likelihood of an unfavorable outcome of the disease.

The combination of hypoxia and arterial hypertension is an unfavorable prognosis factor.

Source: https://GidPain.ru/travma/golovy-posledstviya.html

Brain injury - TBI - Consequences Ⓡ Modern treatment

☝ Brain injury or TBI produces a wide variety of, sometimes severe, consequences. Preventing the consequences of TBI is important for preventing the development of mental illnesses. Prevention and early diagnosis of the consequences of brain injury is one of the main specializations of our rehabilitation medicine clinic.

Our therapeutic methods of restorative medicine in neurology have the ability, in the shortest possible time, not only to prevent consequences, but also to restore most of the processes disrupted by TBI.

We help in the most difficult situations, even when previous therapy did not help. This is achieved by using an individually adapted technique developed by Brain Clinic specialists and approved for use by the international ethical committee of medicine.

The best treatment is prevention. But emergency assistance, provided on time and correctly, gives good results.

Brain injury

• The disorders that occur after a traumatic brain injury are very varied and often very dangerous.
• Doctors distinguish between acute disorders (developing immediately after brain damage) and long-term disorders (appearing long after the injury).
• Call +7 495 135-44-02 we can help you!
• According to statistics, after a TBI, acute symptoms develop within three days; this is the critical period after which, most likely, the most severe consequences of brain injuries should no longer be expected.

The consequences of a traumatic brain injury can be completely unpredictable and very dangerous. The fact is that after a head blow, a so-called “lucid interval” may occur, during which the symptoms of a traumatic brain injury are completely invisible, even when examined by an experienced doctor.

Danger of TBI

This is the great danger, because symptoms of cerebral edema or subarachnoid hematoma can develop only after 24 hours or more. In this case, the patient is in great danger.

1. I have heard more than once from emergency department doctors how subarachnoid or subdural hematomas went unnoticed, which leads to a high risk of patient mortality.
2. Therefore, after a traumatic brain injury, even if you feel well, you must urgently, within a few hours, seek help from a specialist, a neurologist, and carry out the necessary diagnostic procedures.
3. As a result of traumatic brain injuries, a concussion (commotion) can occur - a relatively mild injury or a bruise (contusion) of the brain - a more serious condition.

• Most often they manifest themselves as gross disturbances of consciousness in the form of:
• coma (unconscious state) or
• stupor (a condition resembling stupor),

the duration and severity of which depends on the degree of mechanical impact on brain tissue.

Long-term consequences

Long-term consequences of TBI can manifest as neurological disorders:

• sensitivity disorders (numbness of the hands, feet, burning sensations, tingling sensations in various parts of the body, etc.),
• movement disorders (tremors, coordination disorders, convulsions, slurred speech, stiffness of movements, etc.),
• changes in vision (double vision, blurry focusing)
• mental disorders.

• Mental disorders and behavioral disorders due to brain injuries can be expressed in different conditions: from fatigue to a pronounced decrease in memory and intelligence, from sleep disturbances to incontinence of emotions (attacks of crying, aggression, inadequate euphoria), from headaches to psychoses with delusions and hallucinations.
• The most common disorder in the picture of the consequences of brain injuries is asthenic syndrome.
• The main symptoms of asthenia after traumatic brain injury are complaints of fatigue and rapid exhaustion, the inability to bear additional stress, and unstable mood.
• Characterized by headaches that worsen with exercise.

An important symptom of an asthenic condition that occurs after a traumatic brain injury is increased sensitivity to external stimuli (bright light, loud sound, strong smell).

It is very important to know that much depends on whether the concussion or brain injury occurred for the first time, or whether the patient has repeatedly suffered such injuries at home.

The outcome and duration of treatment directly depends on this.

If a patient has a history of more than 3 concussions, the period of treatment and rehabilitation is significantly longer and the likelihood of complications also increases.

Diagnosis of traumatic brain injury

In case of traumatic brain injury, diagnostic procedures must be performed urgently.

It is also important to be examined and observed by specialists monthly after injury.
As a rule, methods of magnetic resonance imaging, computed tomography, and radiography are used in the diagnosis of TBI.

Treatment of TBI and consequences of brain injuries

In the acute period, decongestant, neurometabolic, neuroprotective, symptomatic therapy is carried out, which consists of selecting several medications offered both in the form of tablets and in the form of injections (drip and intramuscular).

This treatment is carried out for about a month. After which the patient remains under the supervision of his attending physician, depending on the severity of the TBI, from six months to several years.

For at least three months after a TBI, drinking alcoholic beverages and strenuous physical activity is strictly prohibited.

In addition to traditional methods of treating TBI, there are no less effective methods:

• acupuncture,
• osteopathy.

In combination with drug therapy and physiotherapy, these techniques can have a more pronounced and faster effect. However, in some cases they are contraindicated for use.

Everyone knows the fact that treatment must be comprehensive, and the more techniques are used during treatment, the better.

After completing the course of treatment, the patient must be under the supervision of a doctor, and subsequently he may need repeated courses, usually once every six months.

Possible complications

If left untreated, brain injury often causes complications. The most dangerous consequences are considered to be long-term ones, which initially form latently. When, against the background of general well-being, a complex pathology develops without visible symptoms. And only after several months, or even years, an old brain injury can make itself felt.

The most common among them are:

• headaches, often with nausea and vomiting,
• dizziness,
• memory impairment,
• formation of mental pathology, etc.

1. Traumatic brain injuries represent a danger that the patient may not be aware of.
2. After a head impact, various kinds of problems can occur, even when there are no visible symptoms of a concussion (headache, dizziness, vomiting, pressure on the eyes, feeling of fatigue, drowsiness, blurred vision).
3. In many cases, the consequences of brain injury can be accompanied by displacement of the cervical vertebrae, which can also lead to:

• headaches,
• neck pain,
• memory impairment,
• increased fatigue subsequently.

Brain injury is often the trigger for diseases such as:

• facial neuritis,
• pathologies of the trigeminal and other facial nerves.

• this may be accompanied by pain on one side of the face or muscle weakness on one side of the face.
• The Brain Clinic conducts all types of research and comprehensive treatment of the consequences of brain injuries.
• 

Source: https://brainklinik.ru/lechenie-travmy-mozga/

What does a neurosurgeon treat, what operations does he perform, and when should you contact him?

It’s easy to understand what a neurosurgeon treats—he’s a specialized specialist who corrects defects in the nervous system. His difference from a neurologist is that he treats diseases using surgery. Patients are sent to a neurosurgeon when there is no way to get rid of the disease with conservative treatment.

What is neurosurgery?

Neurosurgery is a relatively young branch of medicine that deals with the surgical treatment of diseases of the central and peripheral nervous system.

Although the first mentions of brain surgery date back to the Inca civilization, neurosurgery took shape as a real science at the end of the 19th century.

Thanks to modern achievements in scientific and technological progress, neurosurgeons are able to successfully fight diseases of the brain and spine that until recently led to death.

Sections of neurosurgery

To understand what a neurosurgeon treats, it is useful to familiarize yourself with the sections of this science:

1. Neuro-oncology. He treats tumors located in the brain and spine using surgical operations.
2. Neurotraumatology. Treats the consequences of head and spinal injuries that affect the functioning of the nervous system.
3. Vascular neurosurgery. Specializes in the treatment of blood vessels associated with the central and peripheral nervous system.
4. Spinal neurosurgery. Includes work with diseases associated with the functioning of the spinal cord.
5. Functional neurosurgery. Aimed at improving the functioning of the nervous system, getting rid of problems that interfere with its full functioning.
6. Psychosurgery. Treats some mental illnesses caused by an imbalance in the nervous system.
7. Pediatric neurosurgery. The branch of medicine that deals with the surgical treatment of the nervous system of patients under 18 years of age.

Who is a neurosurgeon and what does he do?

Now almost all people know who a neurosurgeon is. This is a doctor who works with the control system of our body - the brain and spinal cord.

The structure of the nervous system is very complex, so any mistake by a doctor can lead to irreparable consequences and death of the patient. Neurosurgeons study at universities for at least 8 years, after which they need long-term practice.

This profession requires enormous knowledge, attentiveness, practical skills, poise, endurance and patience.

What does a neurosurgeon do?

To fully understand what a neurosurgeon treats, you can refer to the following list:

• congenital anomalies of the brain and spine;
• spinal dysfunction, which leads to neurological syndromes;
• consequences of injuries affecting the functioning of the nervous system (hemorrhages, hematomas, fractures of the skull and spine);
• disturbances in the functioning of blood vessels associated with the activity of the brain and spine;
• inflammatory diseases of the brain;
• dysfunction of the spinal column is what a neurosurgeon-vertebrologist deals with;
• disorders of the blood supply to the brain, strokes, hemorrhages;
• various tumors.

What operations does a neurosurgeon perform?

Operations in neurosurgery involve interventions in the brain or spinal cord. Neurosurgeons use the following types of surgical operations:

• neurorrhaphy - microsurgical intervention to restore the functionality of intertwined nerve fibers;
• stereotoxic radiosurgery – used to treat hard-to-reach tumors by exposure to gamma rays;
• craniotomy - penetration into the brain by cutting the bones of the skull;
• skull reconstruction – performed several months after craniotomy to cover the site of the removed bone with a metal plate;
• shunting – connecting the blood vessels of the brain with the help of a shunt to the body cavity; often used for hydrocephalus in children;
• hemisphere removal - excision of the affected hemisphere of the brain;
• treatment of intervertebral hernia by removal and plastic surgery;
• osteosynthesis – restoration of damaged vertebrae using metal structures.

When to contact a neurosurgeon?

A referral to a neurosurgeon is often given by a neurologist after examining the patient, studying the diagnosis and a comprehensive examination. Consultation with a neurosurgeon may be required in the following cases:

• frequent headaches of unknown origin;
• tumors of the brain and spine;
• head and spine injuries;
• intervertebral hernia;
• nausea and vomiting with unidentified causes;
• epileptic seizures;
• strokes;
• constant insomnia or weakness and drowsiness;
• numbness of the limbs and cramps;
• loss of speech, impaired cognitive processes;
• gait disturbance;
• visual disturbances.

An appointment with a neurosurgeon can be a link in the chain of diagnosing a disease or the end result. If a neurologist, after examining the patient and using hardware diagnostics, discovers problems that need clarification by a neurosurgeon, he issues a referral to this doctor.

You should go to an appointment with a doctor with a statement from a neurologist, with the results of all examinations on film and with conclusions.

The result of a consultation with a neurosurgeon will be either redirection to another doctor, or registration with this doctor and treatment under his supervision.

How is an appointment with a neurosurgeon?

A consultation with a neurosurgeon takes place in a certain sequence:

• familiarization with patient complaints;
• study of anamnesis;
• studying extracts and opinions of other doctors, available diagnostic results;
• examining the patient using a neurological hammer, checking reflexes;
• examination for the presence or absence of symptoms of inflammation of the spinal structures;
• examination of the patient in the Romberg position;
• straight line test.

After a standard consultation procedure, the doctor makes or confirms a preliminary diagnosis. To clarify it, he can resort to other types of examination and prescribe additional hardware diagnostics. If the doctor is convinced that the disease does not fall within his scope, he gives the patient his conclusion and redirects him to another doctor.

What does a neurosurgeon check?

To verify the presence or absence of pathology of the nervous system, the neurosurgeon prescribes the following examinations:

• routine blood and urine examination;
• MRI or CT of the required areas;
• spinal puncture;
• Ultrasound of cerebral vessels - this examination must be prescribed by a vascular neurosurgeon;
• angiography - checking blood vessels using a contrast agent;
• myelography - examination of the spinal cord and spine using a spinal puncture through which a contrast agent is injected;
• encephalography is the study of brain impulses.

Neurosurgeon's recommendations

For problems with the nervous system and spine, the outcome of treatment depends on the correct behavior at the first signs of the disease and in the event of injury.

A neurosurgeon gives the following recommendations regarding patient behavior in such situations:

1. Frequent and severe headaches should not be ignored; they can be caused by serious pathologies of the nervous system.
2. If you experience severe dizziness, lie on your side and close your eyes.
3. Repeated vomiting not associated with gastrointestinal diseases requires specialist diagnosis.
4. You cannot reduce intervertebral hernias; you can cause even greater infringement.
5. During massage, sharp turns of the neck and body should be avoided.
6. If you have a neck or back injury, fix the person's position and call a doctor.
7. You cannot jump into bodies of water where the bottom is unknown.
8. For frequent surges in blood pressure and dizziness, consultation with a neurologist and neurosurgeon is necessary.

Source: https://womanadvice.ru/chto-lechit-neyrohirurg-kakie-operacii-provodit-i-kogda-k-nemu-obrashchatsya

Consultation with a neurosurgeon

Consultation with a neurosurgeon is an important diagnostic component that invariably accompanies the prescription of neurosurgical treatment. A neurosurgeon is a doctor who diagnoses and treats various abnormalities of the central nervous system, as well as eliminating the consequences of injuries to the brain and spinal cord.

The content of the article:

Often the decision to consult a neurosurgeon is made by a neurologist. During the consultation, the doctor not only identifies the disease and makes a diagnosis, but also decides on the need for surgical intervention.

Indications for consultation with a neurosurgeon

There are a large number of different diseases that a neurosurgeon can diagnose and treat. All these diseases can be divided into groups depending on their etiology. Namely, consultation with a neurosurgeon will be needed for the following diseases.

• Vascular: arterial aneurysms, stenoses of precerebral vessels, arteriovenous malformations, carotid-cavernous anastomosis.
• Spinal: spinal stenosis, spinal instability, disc herniation, spinal cord injury.
• Oncological: meningiomas, metastatic brain tumors, tumors of the pineal region and pineal gland, intracerebral tumors, pituitary adenomas.
• Functional: epilepsy, essential tremor, Parkinson's disease, torsion dystonia, hemifacial spasm.

A separate group consists of childhood diseases, which include congenital pathologies of the central nervous system, brain cysts, vascular diseases of the brain, children's cerebral executioner, consequences of traumatic brain injuries, craniostenosis, hydrocephalus of various origins.

Consultation with a neurosurgeon

A free or paid consultation with a neurosurgeon is usually prescribed by a neurologist. This is due to the fact that it is this doctor who is approached by patients with the following symptoms, which may indicate neurosurgical diseases:

• numbness of the limbs;
• dizziness;
• blood pressure surges;
• loss of consciousness;
• lack of coordination;
• noise in ears;
• nausea after head injury.

During an appointment with a neurosurgeon, the patient describes in detail all his complaints, tells the history of the disease: when it started, how it progresses, what symptoms it is accompanied by.

Since the patient often gets a consultation with a neurosurgeon after he has been given a preliminary diagnosis, the doctor needs to study his medical record in detail.

The doctor then performs a neurological examination, paying attention to the areas of the body that will become surgical access sites during surgery.

Additional examinations prescribed by a neurosurgeon

To clarify the diagnosis, as well as prepare for surgery, the following diagnostic techniques are prescribed:

• Computed tomography (CT) scans the brain with X-rays. But based on images taken from different angles, the computer creates a clear image of the brain tumor. To get a clearer picture, a special contrast agent is injected, which allows you to distinguish healthy tissue from a tumor.
• Magnetic resonance imaging (MRI) scans the brain using a magnetic field. MRI provides a detailed image of the tumor. As with a CT scan, a contrast agent will need to be injected in order to take an accurate picture.
• Positron emission tomography is specifically designed to demonstrate all the structures of the brain, as well as the metabolism in it. Such a detailed examination of the brain will help distinguish a tumor from scars and other consequences of surgery.
• Angiography is a detailed study of intracerebral vessels, which involves injecting a contrast agent into the artery and taking X-rays of the head. The vessels of the brain and the anomalies in them become distinct in the images, making them easy to distinguish from each other.
• A stereotactic biopsy is a diagnostic procedure that involves removing part of a tumor to determine its type and malignancy. The tumor is collected using a needle that is inserted into a small hole in the skull.

To carry out the operation, you will also need information about the patient’s blood type, coagulogram and blood test data. In addition, puncture of a cyst or abscess of the brain, lumbar, suboccipital or ventricular puncture, or vertebral biopsy may be required.

Repeated consultation with a neurosurgeon

After the patient has undergone the necessary additional examinations, a second consultation with the doctor will be required. Free or paid consultation with a neurosurgeon in Moscow can be obtained in a large number of clinics. During this procedure, the neurosurgeon must make an informed decision about the advisability of the operation.

If the decision is positive, the patient will be sent to the neurological department to undergo conservative therapy and prepare for surgery. The neurosurgeon must also set a date for the operation and tactics for its implementation.

In some cases, after a second consultation, the doctor may prescribe several additional diagnostic examinations to clarify the characteristics of the affected area.

Source: https://www.mosmedportal.ru/article/konsultatsiya-neyrokhirurga/

Traumatic brain injury

• Basic principles of classification: severity (mild traumatic brain injury, moderate traumatic brain injury, severe traumatic brain injury), combination (isolated, combined, combined), type of damage (focal, diffuse), nature (closed, open non-penetrating, open penetrating), genesis of damage (primary, secondary).
• The following clinical forms of traumatic brain injury are distinguished: Concussion Mild brain contusion Moderate brain contusion Severe brain contusion Diffuse axonal damage
• Brain compression

To understand how dangerous head injuries are, it is enough to know that every hundredth death occurs as a result of a traumatic brain injury. This is one of the most common types of injuries, accounting for approximately half of injuries. Most often, such injuries, which are often incompatible with life, are suffered by people leading an active lifestyle, and you can protect yourself by observing basic safety measures. Today we have learned to treat traumatic brain injury of the head and do it successfully in many institutions, and a positive prognosis depends on the correct diagnosis and choice of medical institution.

Types and main symptoms of TBI

Many uninitiated people are interested in what types of traumatic brain injuries are, to which the answer can be that there are two main types of head injuries: open and closed.

In the first case, damage occurs to the surface of the scalp, skull bone and dura mater, which often leads to irreversible consequences.

Fortunately, less dangerous types of traumatic brain injuries most often occur, such as concussions of varying degrees, compression of the brain under the influence of external factors, head contusions, subarachnoid hemorrhages and others.

The symptoms of most traumatic brain injuries are similar, and as a rule, severe headaches and nausea can be a reason to sound the alarm. It should be borne in mind that there are three degrees of severity of TBI, so the symptoms can differ significantly.

As a rule, with a concussion, in addition to nausea and vomiting, a short-term loss of consciousness occurs; with a mild brain contusion, a person may regain consciousness only after an hour.

A moderate bruise precedes the onset of amnesia, while the respiratory rate increases, heart function is disrupted, and blood pressure increases. The cause of severe contusion is a fracture of the base of the skull and intracranial hemorrhage, as a rule.

When the brain is compressed, loss of consciousness can recur, and it is especially difficult to diagnose the disease in a person in a coma.

Diagnosis and treatment of TBI

High-quality treatment for traumatic brain injury in Moscow is offered, among other institutions, by specialists from the Burdenko Research Institute, where, based on preliminary research data, a correct diagnosis will be made and an effective treatment regimen will be prescribed.

Diagnosis of traumatic brain injury is carried out using MRI and computed tomography devices, but it is also important that the patient is closely monitored by specialists who must monitor breathing, measure pulse and blood pressure.

The most effective treatment for TBI is in the acute period, because in this case the main thing is to prevent secondary brain damage, which is much more difficult to treat.

At the same time, the cost of TBI surgery depends on the severity of the disease and the timeliness of contacting a medical institution, therefore, if you discover unwanted syndromes, you should immediately contact the nearest medical institution.

 Consequences of TBI

Monday	By appointment
Tuesday	By appointment
Wednesday	By appointment
Thursday	By appointment
Friday	By appointment
Saturday	By phone
Sunday	By phone

Source: https://dr-gavrilov.ru/cherepno-mozgovaya_travma/

How can MRI help a patient with a traumatic brain injury and its consequences?

The cold season will come very soon. And with it - ice and snow. During this period, the number of injuries, both domestic and automobile, is steadily growing. A concussion is one of the most common injuries to the nervous system.

With questions about what brain injuries are and what they are like, we turned to Yuri Andreevich Podlevskikh, executive director of Clinic Expert Orenburg LLC.

— Yuri Andreevich, how often do you see patients with traumatic brain injury in your practice?

TBI is a fairly common clinical situation faced by general practitioners, pediatricians, neurologists, traumatologists, and, of course, radiologists. And this is easy to explain.

The mechanism of their occurrence is extensive, ranging from domestic injuries to road traffic accidents.

You can also get a traumatic brain injury during sports competitions or active sports, in particular martial arts.

In our country, statistics on the number of traumatic brain injuries are practically not published, but in the world it is calculated that brain injuries of varying severity occur from 229 to 1967 times per 100 thousand population per year. Thus, on average, 1 in 100 people suffers from TBI and its consequences every year. The most common head injuries occur in men aged 15 to 24 years.

— What are the most common brain injuries? Concussion, brain contusion – are they the same thing or different diagnoses?

Conventionally, brain injuries can be divided into two types of traumatic brain injuries – mild and severe. A mild one is a concussion. More severe is a brain contusion.

I note that a concussion can occur in the absence of a formal injury. For example, a person experienced a sharp acceleration on a ride.

Unlike a brain contusion, in which there is damage to the brain tissue itself, a concussion does not entail morphological or structural changes, so this diagnosis is made clinically. The main symptoms of a concussion are nausea, dizziness, vomiting, and less commonly, retrograde amnesia, which refers to confusion and a vague idea of ​​what happened before the injury.

— Let’s imagine that a child or an adult hits his head. How do you know when you need to see a doctor?

As a doctor who has experience working in a neurosurgical department, I can sadly state that Russians seek medical help late and often refuse hospitalization.

Indeed, if we are talking about a concussion, then modern research has proven that such a patient does not need to remain in bed and rest. But the person himself cannot determine the extent of his injury. The danger also lies in what is called in medicine the “light gap”.

It happens that after receiving a brain injury, the patient decided to “rest” at home and he actually felt better. And a few days later, against the background of the onset of prosperity, a sharp deterioration in the condition occurred. Therefore, you need to remember: a head injury is always a reason to seek medical help from a neurosurgeon.

This is the case when it is really necessary to play it safe.

— Where to go if you have a head injury?

In every city there is a so-called emergency hospital that provides assistance to all those injured on this day and this night. In case of injury, you need to go to the emergency room of the emergency department, where doctors will examine the patient and draw conclusions about the need for specialized treatment.

You can find out the address of such a hospital by calling the number “03”.

But if after receiving an injury a person loses consciousness or there is bleeding, you need to call an ambulance team. You should not take such a patient to the nearest hospital yourself - he needs medical supervision.

— What is included in emergency examinations for traumatic brain injury?

The “gold standard” for traumatic brain injury is computed tomography. This is due to the availability of the method, rapid implementation and its effectiveness in detecting hemorrhages. A CT scan can also help determine if there is a skull fracture.

— Is MRI used for traumatic brain injuries and their consequences?

Magnetic resonance imaging allows a more in-depth study of the conditions of brain tissue. For example, brain contusions are very well visualized on MRI.

In the practice of the Expert Orenburg Clinic, there are often cases when we find in our patients the consequences of traumatic brain injuries decades later, while these same patients underwent computed tomography year after year that did not reveal structural changes in the brain.

• — Why do an MRI for a concussion if the injury is not serious?
• In order to confirm or exclude the presence of structural damage to the brain and, based on the data obtained during diagnosis, choose the correct treatment tactics.
• — How long after a head injury should a dynamic MRI be repeated?
• As a rule, after six months.

— What happens if you approach a traumatic brain injury carelessly, hoping that “everything will go away on its own”? What could be the consequences?

The consequences of TBI are extensive and varied, depending on the nature of the damage and the location of the damage to brain tissue. This can include headaches and slow cognitive functions, as well as deterioration in motor activity of the limbs in the form of paresis and tetraparesis, impaired speech, vision, and hearing.

The most terrible consequence is death.

— How is rehabilitation carried out for patients who have suffered a traumatic brain injury?

If the injury is mild, then specialized rehabilitation is not required. With a concussion, sometimes you don’t even need to take medications. As a last resort, if the headache is intense, the patient is advised to take painkillers; in case of vomiting, antiemetic medications are prescribed. But recommendations should come only from a doctor.

For the rehabilitation of patients with severe brain injuries, both medication and neurorehabilitation are used. It must be remembered: the earlier rehabilitation is started, the faster the patient recovers and returns to everyday life and socializes.

Neurorehabilitation includes classes with instructors, robotic methods with biofeedback, when the device itself evaluates how much a person can perform certain exercises and helps him perform them more effectively. This also includes acupuncture, medical massage, which improves tissue trophism and provides muscle stimulation; electrical stimulation and transcranial magnetic stimulation.

Source: https://www.mrtexpert.ru/articles/396

Traumatic brain injury: why is it dangerous and what should be done first?

Traumatic brain injuries (TBI) are among the most common injuries suffered by people, accounting for approximately half of all injuries. And it is they who often lead to severe health problems. Mostly young and middle-aged people suffer, with children also at risk. The correct tactics in relation to such injuries are based on three pillars: early diagnosis, timely treatment and rehabilitation. This is the only way to prevent the development of dangerous complications and save human health.

In TBI, damage occurs to the head and internal structures of the skull. Impairments can range from mild to severe.

The main danger of such injuries is that even in the absence of obvious symptoms, complications can develop, leading to death or serious disruption of all vital functions of a person. “Since childhood, we have a stereotype - a concussion means loss of consciousness and vomiting.

– says the head of the Interdisciplinary Rehabilitation Center, Alexandra Slavyanskaya. – When you fall, they ask you – did you lose consciousness? Don't you feel sick? Well, ok, everything is fine. You don't even have to go to the doctor.

Important : after hitting your head, even if you feel good, you need to visit a neurologist or traumatologist within a few hours and undergo an examination. Standard studies - x-ray, CT, MRI - will be prescribed by the doctor.

It is especially important that the child is brought to the clinic in a timely manner - often children cannot describe the condition or complain about something specific, parents associate lethargy or tearfulness with a bruise or bad mood, while this is a symptom of a closed head injury.

HOW YOU CAN GET A TRAUMATIC BRAIN INJURY

The most common cause of traumatic brain injury is falls, most often from just one’s own height or slightly higher. Children fall from slides and swings on playgrounds, during wild games or in physical education lessons. Adults often hit their heads while intoxicated, or on icy roads in winter.

There can be many reasons for falls and hitting your head on different surfaces. In addition, of course, people receive a large number of traumatic brain injuries in accidents, fights, inflicted on each other by accident, etc. “Hunters who have received a gunshot wound to the head often come to our rehabilitation center.

Of course, after these lucky ones were treated in the neurosurgical department,” continues Alexandra. – Such tragedies happen due to negligence or because it is customary to “take it to the chest” when hunting. Usually these are very difficult patients who need to restore not only their motor sphere, but also their thinking, cognitive functions, and hearing.

However, the fact that they survived can already be considered a miracle.”

POSSIBLE SYMPTOMS OF TBI

TBI has certain symptoms, but it happens that there are no warning signs at first. There is such a thing as a “light period” - a period of time when signs of injury are not yet noticeable.

As we said above, if you think that feeling normal after a head injury is a guarantee that there will be no consequences, you are mistaken. These effects can be long-term and appear months and years after the injury.

Therefore, contacting a neurologist is the best thing you can do, even if what you think is a minor incident has happened.

What symptoms are typical for TBI:

• Loss or confusion of consciousness, hallucinations;
• Your head may hurt or feel dizzy;
• Nausea, even vomiting;
• Memory impairment;
• bleeding from the nose or ears;
• Hematomas around the eyes or behind the ears;
• Ringing sounds in the ears;
• Speech disorders;
• Convulsions;
• Weakening pulse
• Children after TBI are often characterized by lethargy, tearfulness, moodiness, and weakness.

All of them are reasons to immediately call an ambulance.

EXAMINATION AND TREATMENT OF TBI

In the next few hours after the incident, you need to go to a medical facility and undergo an examination. An MRI or CT scan of the brain is mandatory. These tests can determine the type, location, extent of damage, presence of brain swelling, and many other factors.

MRI is a more informative and accurate study, in particular, when diagnosing cerebral ischemia, intracranial hematomas, to assess the metabolism of brain areas, the level of damage to nerve fibers, etc. In addition to MRI, an examination is carried out, tests are taken, and all physical and neurological indicators are assessed.

Craniography, electroencephalography and other studies may be required based on the type, severity of injury and medical history.

Treatment for TBI in the acute stage can be surgical and conservative.

Conservative treatment consists of pain relief, symptomatic, decongestant, neuroprotective and other necessary therapy in the hospital or at home (for minor injuries).

The patient needs to be provided with bed rest, and then with gentle rest and medical supervision. The main goal of any treatment is to reduce the risk of complications after injury.

“The period of active treatment for TBI is always individual and depends on the severity of the injuries received and a number of other medical components. For some it is a month, for others it is a year. But after treatment, it is necessary to immediately begin rehabilitation, says Vasily Kupreichik, leading rehabilitation specialist at the ICR.

– The period of active rehabilitation ranges from 3 months to six months, depending on the patient’s condition and the characteristics of the injury.

This is a rather complex process that must also be included in the patient’s recovery for the underlying disease - for example, in the case of open injuries, prosthetics of a part of the skull is necessary, and before and after prosthetics, the rehabilitation program may be different. Traumatic brain injuries are a complex topic in rehabilitation.

After a TBI, the patient may be in a very serious condition for a long time. We are faced with situations where the patient’s condition after TBI was mistakenly recognized as vegetative, the cerebral cortex as dead, and accordingly, such patients are recognized as having no rehabilitation potential.

The goal of rehabilitation after a TBI is to return a person to a full life, improving, as far as possible, his physical and psychological condition.

The rehabilitation program may include physical therapy, physiotherapy, kinesiotherapy, occupational therapy, massage, reflexology, sessions with a psychologist or psychiatrist, speech therapist and much more.

As a result of such restoration, the patient’s quality of life is significantly increased, and the risk of complications is reduced. It is only important to start the rehabilitation process in time - when time has not yet been lost and health can be restored.

“Working with relatives is extremely important. – says Vasily Kupreichik. – A serious injury to a loved one is a turning point in the life of a family; people need to understand how to cope with grief.

The family can be hyper-mobilized, ready to put their loved one back on their feet at any cost, without seeing the limitations of their capabilities and the capabilities of doctors. Or, on the contrary, give up and be depressed.

It is very important for us to work together with the family and, on the one hand, to achieve a clear understanding of the patient’s capabilities, to rid the family of illusions, otherwise energy, money and years of life will be spent on achieving unattainable goals; on the other hand, it is necessary to support family members, get them out of depression, and set them up for long work that will produce results. Yes, often recovery occurs faster than we expect, but we must remember that rehabilitation is not a magic pill, not a wave of a magic wand, it is a long job, and not only for the patient.”

What happens if the patient cannot be fully restored? “We immediately tell relatives about what can and cannot be achieved. (Vasily Kupreichik). We say that the goal of our work is not to recreate what was, but to normalize human life. Even if irreversible changes have occurred to him. After trauma, none of us are the same.

Even if you break your finger, it will still react to weather changes for a long time, whine - there will be consequences even for a very minor injury. And in the case of a significant injury, they will be even more so, but our task, by restoring a person to the highest possible level, is to return him to the joy of life in the new realities that exist.

He is alive, he is next to you - this is the main thing, and we will help with the rest.”

___________________________________ Source: www.mcr-clinic.ru

Source: https://zen.yandex.ru/media/id/5b1ab979de147500aaf8deb4/5b55e14b3262f900a93b1ad8