What Are the Common Causes of Cerebellum Damage?

Craniocerebral injury is a common trauma, which can exist alone or in combination with other injuries. The classification is divided into scalp injury, skull injury and brain injury according to the anatomy of the brain. The three can be combined. Scalp injuries include scalp hematoma, scalp laceration, and scalp avulsion. Skull fractures include linear skull fractures, skull base fractures, and depression fractures. Brain injuries include concussion, diffuse axonal injury, cerebral contusion and laceration, and brain stem injury. According to the time and type of injury, it can be divided into primary head injury and secondary head injury. According to whether the contents of the cranial cavity are in communication with the outside world, it is divided into closed head injury and open head injury. According to the degree of injury, it can be divided into four types: light, medium, severe, and severe.

Basic Information

English name: craniocerebral injury
Visiting department: neurosurgery
Common locations: Scalp, skull and brain

Common causes: Traffic accidents, falls from heights, falls and falls, work-related accidents and firearm injuries, occasional traumatic brain injuries caused by forceps for dystocia, etc.
Common symptoms: Mental disorders, cerebral edema, cerebral hernia, etc.

Causes of craniocerebral injury

Common causes of craniocerebral injury in peacetime are traffic accidents, falls from heights, falls and falls, work-related injuries and firearm injuries; occasional traumatic brain injuries caused by dystocia and forceps. The main causes of craniocerebral injury during wartime include the collapse of houses or fortifications, and the impact of high-pressure shock waves from explosive weapons.

Clinical manifestations of craniocerebral injury

General performance

(1) Impaired consciousness The vast majority of patients experience loss of consciousness after injury, varying in length of time. Disorders of consciousness manifest from drowsiness, obscurity, shallow coma, coma, and deep coma.

(2) Headache and vomiting are common symptoms after injury. If it is getting worse, be careful of intracranial hematoma.

(3) If the pupil is dilated immediately after the injury, the light reaction disappears, and the patient is awake, usually the primary primary injury of the oculomotor nerve; The pupils of both sides are extremely narrowed, and the photoreaction disappears, which is usually the pontine injury. If the pupil of one side is first reduced, and then dilated, the photoreaction is poor, and the patient's consciousness is aggravated. The scatter is fixed, the light response disappears, and most of them are endangered.

(4) Breathing, weak pulse, rhythm disturbance, and blood pressure decrease after vital signs injury, generally return to normal after a few minutes and more than ten minutes. If the vital signs are prolonged and there is no sign of recovery, it indicates that the brainstem injury is severe; if the vital signs have returned to normal after the injury, blood pressure gradually increases, breathing and pulses slow down, often suggesting a secondary hematoma in the skull.

2. Special performance

(1) The neonatal craniocerebral injury is almost always caused by birth trauma, and is generally manifested as scalp hematoma, skull deformation, high cardiac cardia tension or frequent vomiting. Infants and young children have more subperiosteal hematomas and are prone to calcification. Children are prone to table tennis-like depressions. Infants and preschool children have severe post-injury reactions, obvious signs of vital disorders, and prone to shock symptoms. There are often delayed manifestations of consciousness. The clinical manifestations of intracranial hematoma in children are mild, cerebral hernia appears late, and the condition changes rapidly.

(2) Elderly patients have a long disturbance of consciousness and significant changes in vital signs after craniocerebral injury . Early symptoms are not obvious when intracranial hematomas occur, but vomiting is common and symptoms develop rapidly.

(3) Severe craniocerebral injury can often cause water and salt metabolism disorders, hypertonic hyperglycemia, non-ketocoma, cerebral pulmonary edema and brain death.

Craniocerebral injury examination

1. X-ray plain film inspection

X-ray plain radiographs include tangential plain radiographs of the upright, lateral, and trauma sites, which are helpful for the diagnosis of skull fractures, intracranial effusion, intracranial bone slices, or foreign bodies, but patients with severe injuries should not be forced. When the skull is linearly fractured, be careful not to confuse it with the skull suture.

2.CT inspection

CT examination can quickly and faithfully reflect the extent of injury and pathology, and can dynamically observe the development and outcome of lesions, but it is still difficult to diagnose lesions of equal density, located at the base or top of the skull, or in the brain stem or with smaller volumes.

(1) Scalp hematoma The most prominent manifestation of scalp soft tissue injury is a subcapsular aponeurotic hematoma, which is a high-density shadow, often accompanied by a depressed fracture, acute subdural hematoma, and brain parenchymal injury.

(2) CT of skull fracture can quickly diagnose linear fracture or depression fracture with epidural hematoma or brain parenchymal injury. CT bone window imaging is more valuable for the diagnosis of skull base fractures, and can understand the fractures of the optic canal, orbit and sinuses.

(3) Brain contusion and laceration are common in the frontal and temporal parts, and are often accompanied by intracerebral hematomas, subarachnoid hemorrhage and other manifestations. The density of contusion and laceration changes, and large contusion lesions surround the area. There is obvious edema response, and space effects such as narrowing of ventricle and cerebellar displacement can be seen.

(4) Intracranial hematoma Acute epidural hematoma is typically manifested by a biconvex lens-shaped density increase on the inner skull plate and the brain surface. Acute subdural hematomas appear as crescent or semilunar high-density areas on the brain surface. In the chronic subdural hematoma, a crescent-shaped, semi-lunar-shaped mixed density or isodensity shadow can be seen under the skull inner plate, the midline is shifted, and the ventricle is compressed. Intracerebral hematoma manifests as round or irregular high-density or mixed-density hematoma near the contusion and laceration or deep white matter.

3.MRI examination

MRI has obvious advantages for subdural hematomas of the same density, mild cerebral contusion and laceration, small focal hemorrhage, traumatic cerebral infarction at the beginning, and thin-layer hematomas at the base of the skull, cranial skull, or posterior cranial fossa. Not suitable for restless, uncooperative or critically ill patients.

Brain injury diagnosis

The injury should be judged from the following aspects: state of consciousness, vital signs, eye signs, dyskinesia, sensory disturbance, cerebellar signs, head examination, cerebrospinal fluid leakage and injury. In addition, factors affecting judgment such as injury after drinking, taking sedatives, strong dehydration, and shock should be considered. In addition to the injury mechanism and clinical signs of patients, the early diagnosis of craniocerebral injury should be based on fast and accurate examination methods. CT scan is preferred.

Craniocerebral injury treatment

Non-surgical treatment

The vast majority of patients with mild, medium and severe head injury are mainly treated by non-surgical treatment. Non-surgical treatment mainly includes intracranial pressure monitoring, mild hypothermia treatment, dehydration treatment, nutritional support therapy, respiratory tract treatment, prevention and treatment of cerebral vasospasm, treatment of common complications, treatment of water-electrolyte and acid-base balance disorders, antibacterial treatment, and nerve Protective drugs, etc.

2. Surgical treatment

The principles of surgical treatment of craniocerebral injury save patients' lives, restore important functions of the nervous system, and reduce mortality and disability. Surgical treatment is mainly aimed at open head injury, closed head injury with intracranial hematoma, or complications or sequelae caused by traumatic brain injury. The main surgical methods include decompression of the large bone flap, debridement of craniotomy hematoma, debridement, depression fracture repair and skull defect repair.