What Are the Different Types of Brain Trauma?

Brain trauma refers to injuries caused by foreign objects that are visible to the naked eye, and can generally cause serious consequences. Brain trauma often causes varying degrees of permanent dysfunction. This mainly depends on whether the damage is in a specific area of the brain tissue (focal) or extensive (diffuse). Brain damage in different areas can cause different symptoms. Focal symptoms include symptoms such as motor, sensory, speech, vision, and hearing disorders. Diffuse brain damage often affects memory, sleep, or leads to confusion and coma.

Causes of brain trauma

Sudden acceleration of the head can cause brain tissue damage just like slamming the head.

Rapid head impact on hard objects that cannot move or sudden deceleration are also common causes of brain trauma.

Brain tissue on the impacted side or in the opposite direction is extremely vulnerable to collision with a hard and convex skull. Acceleration-deceleration injuries are sometimes called contralateral impact injuries.

Clinical manifestations of traumatic brain injury

Brain oscillation syndrome

A brief loss of consciousness occurs after a brain oscillation and usually recovers within 30 minutes. After waking up, the patient could not recall the scene at the time of the injury and the situation before the injury. Patients may have headaches, vomiting, dizziness, irritability, emotional instability, lack of self-confidence, attention dispersal, autonomic symptoms such as pale skin, cold sweats, decreased blood pressure, slow pulse, and slow breathing.

2. Coma due to traumatic brain injury

After a traumatic brain injury, there may be a coma of varying duration, from coma to recovery, with drowsiness, turbidity, and delirium in the middle. The disturbance of consciousness is volatile when it is mild.

3. delirium caused by brain trauma

Delirium usually turns from coma or lethargy. The behavior of some patients during delirium reflects pre-ill occupational characteristics. Many patients are resistant, noisy, uncooperative, and others are more aggressive. There may be horror hallucinations, severe patients may have chaotic excitement, and even strong impulsive sexual violence. Delirium can be replaced by other disturbances of consciousness such as blindness and dream-like states.

4. Amnesia syndrome caused by brain trauma

Its most prominent feature is fiction on the basis of forgetting, which is often irritable to patients. Its duration is shorter than that of alcoholic amnesia syndrome.

5. Subdural hematoma caused by brain trauma

It can occur soon after an injury, and headaches and drowsiness are common. Occasionally accompanied by delirium motor excitement, about half of patients have papillary edema. Chronic subdural hematomas are characterized by drowsiness, dullness, memory loss, severe symptoms of generalized dementia, some patients with mild increase in cerebrospinal fluid pressure, quantitative increase in protein, and yellow appearance.

Brain injury examination

1.X-ray plain film

Judge fractures, separation of cranial sutures, intracranial gas accumulation, and intracranial foreign bodies.

2.CT scan

A very important method can show the existence and scope of hematoma, contusion and edema, and also see fractures and gas accumulation. If necessary, dynamic scanning can be performed multiple times to track changes in the condition. But the posterior cranial fossa often has artifact interference, and the imaging is not good.

3.MRI

Although it is rarely used in the acute phase, it should be considered when the posterior cranial fossa lesion is poorly displayed on CT. Intracranial soft tissue structure imaging is better than CT, which can be used to judge the extent of injury and estimate the prognosis after the disease is stable.

4. Lumbar puncture

Can measure intracranial pressure and test cerebrospinal fluid. Craniocerebral injury with subarachnoid hemorrhage can release bloody cerebrospinal fluid through lumbar puncture, and it is also an important treatment method.

5. Cerebral angiography

It is less common to diagnose with craniocerebral injury, but it should be applied in time when vascular disease is suspected. The presence of a hematoma can be determined based on vascular morphology without a CT machine.

6. Other inspection methods

Ultrasound, EEG, radionuclide imaging, etc. have little significance and are rarely used directly in the diagnosis of craniocerebral injury.

Brain trauma diagnosis

The diagnosis of craniocerebral trauma is easier to establish based on the patient's injuries, physical examination of the whole body and nervous system. The above examinations can be performed to confirm the diagnosis.

Brain trauma complications

1. Brain injury often causes varying degrees of permanent dysfunction. This depends mainly on whether the damage is in a specific area of the brain tissue (focal) or widespread (diffuse). Brain damage in different areas can cause different symptoms. These special focal symptoms help Doctors determine the location of the injury. Focal symptoms include symptoms such as movement, sensation, speech, vision, and hearing abnormalities, while diffuse brain damage often affects memory, sleep, or causes confusion and coma.

2. Patients with severe brain trauma sometimes cause amnesia. Patients cannot recall events before and after the loss of consciousness, and patients who are awake within a week can often restore memory. Some brain trauma (even minor) can cause post-traumatic syndrome. For a long time, patients experience headaches and memory disorders.

3. Severe traumatic brain injury can pull, twist or tear nerves, blood vessels and other tissues in the brain. Nerve pathways are damaged, or bleeding and edema are caused. Intracranial hemorrhage and cerebral edema increase the contents of the cranial cavity, but the cranial cavity itself cannot be enlarged accordingly. As a result, the intracranial pressure increases and the brain tissue is further damaged. At this time, the increased intracranial pressure moves the brain downward, forcing the upper The brain tissue and brain stem enter the associated channels, a condition called a hernia. The cerebellum and brain stem can be displaced from the foramen of the skull base to the spinal cord. Because the brain stem has important functions to maintain breathing and heartbeat, cerebral hernias are often fatal.

Brain trauma treatment

Psychological and behavioral therapy

Concerned about the condition, enlightened, and relieved the patient's misunderstanding that "sequelae of concussion cannot be cured". Patients should be concerned about their illness, be patiently enlightened, and relieve their anxiety, so that they can build up their confidence in order to understand and overcome the disease. Create a good medical living environment for patients and avoid all kinds of bad stimuli from the outside. Encourage patients to get out of bed, participate in more outdoor activities, exercise, regularize their lives, correct bad habits and hobbies, resume work as soon as they can, learn new knowledge and skills, take an active part in social interactions, and establish good interpersonal relationships. A cheerful mood, emotional stability, smooth work, and family harmony are more conducive to complete physical, mental, and social adaptation.

2. Symptomatic treatment

Analgesics can be given for headaches, but narcotics or morphine drugs should not be used to avoid addiction. For example, L-Goldenine, enteric-coated aspirin, naproxen, ibuprofen, etc .; dizziness can be given to diphenhydramine, trichlorot-butanol, etc .; autonomic dysfunction can be given to oryzanol, promethazine, gamma-aminobutyric acid (-aminobutyric acid), methylphenidate (methylphenidate), atropine (atropine sulfate), scopolamine, etc .; Excited patients can be given perphenazine, diazepam (anazepine), oxazepam (normethylhydroxyl) Diazepam), etc .; Depressed patients can be given glutamic acid, -aminobutyric acid.