Brain bruise
Description:
The brain bruise (Latin of contusio cerebri) — a craniocereberal injury at which there is a defeat directly of brain tissues is always followed by existence of the center of a necrosis of nervous tissue. Most often the centers of damage are located in the field of frontal, temporal and occipital lobes. The damages which developed at an injury can be both unilateral, and bilateral.
Brain Bruise symptoms:
Distinguish a bruise of a brain of easy, average and heavy severity depending on depth and duration of a loss of consciousness.
Bruise of a brain of easy degree.
The bruise of a brain of easy degree is characterized by a short loss of consciousness after an injury (of several to tens minutes). After a bruise patients complain of a headache, dizziness, nausea, vomiting. Sometimes moderate bradycardia or tachycardia meets, there is arterial hypertension. Body temperature is normal. Fractures of bones of a calvaria and subarachnoidal hemorrhage are possible.
Bruise of a moderately severe brain.
The bruise of a brain of moderate severity is characterized by more long loss of consciousness after an injury, than at an easy form (of several tens minutes till several o'clock). After a bruise patients complain of a severe headache, repeated vomiting is observed. There can be disturbances of mentality. Bradycardia or tachycardia, increase in the ABP, a tachypnea meets. Meningeal symptoms are often expressed. Fractures of bones of a calvaria and subarachnoidal hemorrhage are possible. Cerebrospinal fluid with the expressed blood impurity.
Bruise of a brain of heavy degree.
The bruise of a brain of heavy degree is characterized by a long loss of consciousness after an injury (from several hours to several weeks). Motive excitement is usually expressed. Domination of trunk neurologic symptoms is observed (a multiple nystagmus, swallowing disturbances, a bilateral mydriasis or a miosis, a gormegoniya, etc.). Paresis of extremities can come to light. Meningeal symptoms are often expressed. Fractures of bones of a calvaria and massivno subarachnoidal hemorrhage are possible. Heavy bruises of a brain often lead to a lethal outcome.
Brain Bruise reasons:
Usually happens in a point of application of the injuring force, but it can be observed also on the party, opposite in relation to an injury (a bruise from antiblow). At the same time there is a destruction of a part of brain fabric of blood vessels, histologic bonds of cells with the subsequent development of traumatic hypostasis. The zone of such disturbances is various and is defined by weight of an injury.
The bruise of a brain is characterized by a combination of fabric focal damages of various degree of manifestation and primary traumatic hemorrhages in bark and white matter of a brain. Further the center of a bruise extends owing to hemorrhages, hypostasis swelling of a brain and hemodynamic frustration.
The brain bruise, as a rule, is followed by subarachnoidal hemorrhage and a meningeal syndrome of various degree of manifestation which usually develops through 4 - 6 - 8 h after an injury as a result of direct damage of covers, hypostasis - brain swelling and, the most important, toxic impact of decomposition products of hemoglobin on a meninx. In certain cases the bruise of a brain is followed by a change of the arch or a base of skull. Almost at a half of patients after a heavy bruise of a brain the intracranial hematoma forms.
Treatment of the Bruise of a brain:
Obligatory hospitalization and bed rest. Duration of a bed rest at a bruise of a brain of easy degree makes 7 — 10 days, at UGM of average degree to 2 weeks depending on a clinical current and results of tool researches. At a severe craniocereberal injury (the crush centers, diffusion axonal damage) resuscitation actions which begin at a pre-hospital stage are necessary and continue in the conditions of a hospital. For the purpose of normalization of breath provide free passability of upper respiratory tracts (release them from blood, slime, emetic masses, introduction of an air duct, a trachea intubation, a tracheostomy), use inhalation of oxygen air mixture, and if necessary carry out artificial ventilation of the lungs.
Surgical treatment is shown at a brain bruise with crush of its fabric (most often arises in the field of poles a frontal and temporal lobe). Operation essence: the osteoplastic craniotrypesis consisting in creation of an opening in calvaria bones for the purpose of ensuring access in his cavity and washing away of a brain detritis a stream of 0,9% of NaCl solution, a bleeding stop.
