Brain concussion is one of the most common causes of childhood trauma. This type of brain disorder refers to mild craniocerebral injury, although it causes in most cases fear and anxiety of parents.
What is a concussion in children?
This brain function damage is considered to be a fairly harmless kind of injury, after which a small trail of a bruise, a wound or a cone may remain on the head, but the skull remains intact.
The very definition of trauma is a concussion of the brain, which means that there is a kind of "shaking of the head", in which there are no significant changes in the structure.
Moreover, if there was a possibility to look inside the skull when diagnosing, no specialist would notice anything concrete, as the changes in this trauma occur on the smallest cellular level.
Consider the medical statistics of this pathology:
- the proportion of craniocerebral lesions of childhood occupies a leading position among all types of injuries;
- annually about 125 thousand children become patients of traumatology department of Russian hospitals due to concussion;
- diagnoses a brain concussion in 9 cases out of 10 cases due to a traumatic brain injury;
- age specific characteristics of the affected: newborns - 2%, infants - about 23-25%, children from 1 to 4 years - 7-8%, preschool children - 20-22% and schoolchildren - more than 45%.
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The main causes of
Consider the reasons for this rather high level of injuries for each age group separately.
- In a child under one year, the trauma under consideration is primarily a result of negligent care and carelessness of young parents. In the overwhelming majority of cases, babies get a concussion after falling from the crib, changing chair, from the hands of adults, from the stroller, etc.
In this case, the baby, as a rule, falls head down, which has more weight relative to the trunk, because he does not yet know and can not substitute his hands for protection against a strong blow. That is why even in the maternity home, all mothers are advised not to leave the child unattended, if not, then follow the precautionary measures. - In children from 2-3 to 6 years, the main factors are the following:
- increased motor activity of the child;
- imperfection of coordination of movements and motor skills;
- absence of a pronounced sense of danger and fear of heights.
In principle, after any child starts walking alone, injuries can not be avoided. And they are of a very diverse nature, where the head suffers chiefly from a stroke. Due to age, the child is very inquisitive, and unchecked trying to master all the new boundaries of the unknown, therefore, and there are troubles in the form of falls.
- In schoolchildren, according to many experts, often craniocerebral injuries remain hidden for various reasons. And not everyone runs to the doctor at once, but only if they feel unwell in the future. And it is worth noting that in adult children, brain concussion can be observed without traumatizing the head, for example, with sudden braking or acceleration.
Symptoms and signs of
As it was already noted, with this brain damage, there are no gross irreversible processes of disturbance. This trauma, despite the increased frequency of cases, has the most favorable prognosis for recovery, and rarely causes complications.
Symptomatic of concussion in a child before the year , as a rule, has no pronounced character. If there are suspicions, the clinic is as follows:
- vomiting, more often single, rather than multiple;
- frequent regurgitation when feeding, more than usual;
- fontanelle swelling;
- pale skin color, especially the face;
- increased excitability - capriciousness and crying;
- poor appetite or none at all;
- restless sleep, increased fatigue.
At 2 years old the child can already tell or show if he has any signs of concussion. Symptomatic pathology in children 2-3 years to 6:
- possible loss of consciousness - the child can not explain what happened to him, and how he fell;
- nausea and increased gag reflex;
- slowing heart rate;
- dizziness combined with headache;
- sweating;
- tearfulness;
- pale skin;
- is a bad restless sleep.
With a strong impact, a short-term loss of visual acuity, called in posttraumatic blindness in medicine, is possible. This symptom does not always develop right after the injury, it can flow from several minutes to several hours, gradually fading and fading.
The temperature of a child's concussion is unstable, that is, its increase or decrease is not related to this type of brain injury.
Symptoms in schoolchildren is manifested by the following symptoms:
- apparent loss of consciousness, lasting up to 15 minutes;
- persistent nausea and vomiting;
- intense headaches;
- memory loss regarding the nature and causes of injury;
- presence of neurologic symptoms of a specific nature( eg, eyeballs twitching syndrome);
- marked violation of coordination of motor activity.
A characteristic feature of the clinic for the concussion of the child's brain is its property of growth. That is, immediately after the trauma the child can feel quite satisfactorily, and over time, the condition deteriorates noticeably.
First aid for children with concussion
If a child bumps his head or falls, in any case it is worth to seek the qualified help of a specialist. If it is impossible to provide medical assistance, the following actions can be applied:
- if the child is conscious, lay him on a hard surface and cover with a blanket;
- if the child has lost consciousness, then it should be laid on the right side, while for a stable position and creating the conditions for proper breathing, the left leg and arm should be bent at an angle of 90 degrees;
- with uneven breathing and delayed pulsation, if possible, artificial respiration and cardiac massage can be done;
- fully inspect the child for fractures or bruises, if there are bleeding wounds, they should be processed.
Diagnosis measures
For suspected concussion, the following measures are assigned to clarify the diagnosis:
- X-ray - this study is prescribed in most cases in order to exclude fractures of the skull.
- Ultrasound examination - this type of diagnosis allows you to assess the state of the brain.
- Neurosonography - this study is usually administered to children under 2 years of age who can diagnose the presence of the following brain disorders:
- edema;
- hematoma;
- hemorrhage.
- Echo-encephalography is an ultrasound study that reveals biases that indicate indirectly the presence of hematomas and tumors. This method is effective in the application of older children, since the skull bones they have already thickened. However, there are disadvantages - the method is not reliable enough.
- Computed tomography is the most common and effective method, it allows to reveal to the smallest detail all the brain damage, which helps the specialist to establish a complete picture of the child's condition.
Additional methods include magnetic resonance imaging, lumbar puncture, electroencephalography.
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Treatment
The basic principle of treating a child who has this pathology diagnosed is absolute restand specialist supervision for some time.
- It is desirable to have in-patient monitoring for several days in order to detect early serious injuries and to prevent complications.
- Restriction of motor activity, even if the patient is feeling fine.
- Complete exclusion of watching TV, computer games, sports activities.
Drug treatment involves the appointment of the following drugs:
- Diuretics for the elimination of cerebral edema and other effects after the stroke - Diakarb, Furosemide. These drugs are used in a mandatory combination with potassium-based drugs( Asparcum, Panangin).
- Means that stimulate the supply of sufficient nutrients to the brain and improve its circulation - a group of nootropic drugs( Cavinton, Pyracetam).
- Calming agents - for example, fenozepam or an infusion of valerian.
- Antihistamines - Suprastin, Fenistil, Diazolin.
- Painkillers - analgesics( Sedalgin, Baralgin).
- Means for stopping nausea - Cerucal.
- Vitaminotherapy.
Consequences and complications of
Despite the fact that this type of injury refers to mild pathologies, they have a place to be. The consequences of concussion include:
- persistent headaches of an intense, prolonged nature;
- is inhibited in carrying out the usual daily activities;
- periodic seizures of vomiting for no apparent reason;
- irritability from games and activities that bring joy before injury;
- meteorological dependence - any weather change affects the child depressingly, manifested by headaches and malaise;
- sleep disturbance, rarely insomnia.
Most often, negative symptoms of concussion disappear with the passage of some time without treatment, but with their persistent manifestation it is necessary to visit a specialist to avoid irreversible disorders.
Explanations of Dr. Komarovsky on brain concussion in children
- Brain concussion is a medical condition that has a specific symptomatology in the form of short-term loss of consciousness and does not require specialized treatment.
- A sufficient condition for recovery after a trauma is rest and peace in a horizontal position with an absolute limitation of jumps and walking.
- In children, metabolic processes occur so with high intensity that additional stimulation, even after trauma, is not required.
- The risk of complications after concussion can not be prevented by medication.
In the video, Dr. Komarovsky answers questions about brain concussion in children - how to diagnose concussion correctly and whether to take a large number of medications while treating it:
In conclusion, I would like to note that the concussion of most boys and some girls of school age-this is a certain step in development and growing up, so on the one hand you should not panic. And on the other, it is absolutely necessary to carry out diagnostics and take the necessary measures for the speedy recovery of the child.