1 Causes and classification of the disease
Consequences of CCT in ICD-10 have code T90.5. Craniocerebral trauma is fixed when the soft tissues of the skull, as well as the brain, are damaged. The most common cause is:
- striking the head;
- road accident;
- sports injury.
All craniocerebral injuries are divided into 2 groups:
- open( penetrating and non-penetrating);
If an injury has occurred and the integrity of the soft tissue of the head has been violated, then this is a group of open injuries. If at the same time the bones of the skull were damaged, but the dura mater remained intact, then the injuries are classified as non-penetrating. Penetrating them are called in the event that the bones were damaged and the hard shell too. Closed form is characterized by the fact that soft tissues are not affected, without aponeurosis, broken bones of the skull.
Given the pathophysiology of CCT, there are lesions:
- Primary. In this case, the vessels, skull bones, brain tissue, as well as the shell, are injured, and the cerebrospinal fluid system is also affected.
- Secondary. Do not have a direct connection with brain damage. Their development occurs as a secondary ischemic change in the brain tissues.
There are injuries causing complications, the most common among them:
- is a hematoma.
The degree of severity is necessarily taken into account:
- Light. Consciousness is clear, there are no pains, especially it does not threaten health.
- Average. Consciousness is clear, but it is also possible that a person feels a little stunned. Expressed focal features.
- Heavy. There is a sopor, a strong stunning. Vital actions are violated, there are focal features.
- Extremely heavy. The patient falls into a coma, not long or deep. Vital functions are severely impaired, as well as cardiovascular and respiratory systems. There is a focal symptomatology. Consciousness is absent from a couple of hours to many days. The movements of the eyeballs are not sharp, and the pupils' reaction to the bright stimuli is suppressed.
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2 Diagnostic methods and periods of illness
Patients with traumatic brain injuries should be screened. On the basis of determining the degree of oppression of consciousness, the extent to which neurological symptoms are expressed, other organs are damaged, a diagnosis is made. It is most convenient for these purposes to use the Glasgow coma scale. Check the condition of the patient immediately after the injury, after 12 hours and after a day.
The patient is asked to make certain movements, answer questions and open and close his eyes. At the same time, the reaction is monitored with external irritating factors.
In medicine, several periods of the disease are distinguished:
- in between;
If there is a concussion, then most often the patient experiences a sharp headache. Possible loss of consciousness, vomiting, dizzy.
A person experiences weakness, becomes sluggish. But there is no stagnation in the fundus, the brain is not locally affected, the cerebrospinal fluid has the same pressure.
If a brain injury occurs, the person is followed by a headache in the place of impact, constant vomiting, there is shortness of breath and bradycardia, pallor and fever. In the examination,
- in the cerebrospinal fluid is detected - the presence of blood;
- in the blood - increased number of leukocytes.
Vision and speech may be impaired. At this time, it is necessary to be under medical supervision, since traumatic epilepsy accompanied by seizures may occur. And this process often causes depressive states and aggressive behavior, rapid fatigue.
Intracranial bruises, cranial fractures depressed can cause compression of the brain. This is due to various types of hemorrhages resulting from injuries. Often, due to a hemorrhage that occurred between the bones of the skull and the medullary membrane, it is at the point of impact that epidural hematoma occurs. It can be determined from the anisocoria with the extension. Loss of consciousness is not uncommon. With this diagnosis, surgical intervention is most often required.
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With subdural hematoma from the impact there are severe head spasms, vomiting, blood begins to collect in the subdural space. There are cramps. Patients can not navigate in space, quickly become tired, but are too excited and irritable.
To confirm the diagnosis caused by a bruise near the skull, additional studies will be needed:
- X-ray of the skull, when there is a suspicion of its fracture.
- EMG will help determine what degree of damage is in the muscle fibers and the myoneural endings.
- Neurosonography. With its help, intracranial hypertension, hydrocephalus is defined.
- UZDG to check if there was a pathology in the vessels of the brain.
- Biochemical blood test.
- MRI to determine lesions in the brain.
- EEG for the detection of dysfunction of the brain stem structures.
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Diagnosis will determine the consequences of a trauma to the skull.