What is a Concussion?

Refers to a transient brain dysfunction immediately after the head is hit by an external force. There are no obvious changes in pathological changes, and there are still many debates on the mechanism.

[no zhèn dàng]

Refers to a transient brain dysfunction immediately after the head is hit by an external force. There are no obvious changes in pathological changes, and there are still many debates on the mechanism.

Clinical manifestations were transient coma, retrograde amnesia, and headache, nausea, and vomiting. No positive signs were found on neurological examination. It is the lightest type of brain injury and most can be cured after treatment. It can occur alone or in combination with other craniocerebral injuries such as intracranial hematoma. Differential diagnosis should be made in time.

TCM disease name

concussion

English name

brain concussion

Visiting department

neurosurgery

Multiple groups

Accidental injury

Common locations

head

Common causes

Caused by external force on the head

Common symptoms

Transient coma, retrograde amnesia, and headaches, nausea, and vomiting

Contagious

no

The mechanism of concussion is still controversial. It is generally believed that the disturbance of consciousness caused is mainly the result of damaged brainstem reticular structure. This damage is related to factors such as the impact of cerebrospinal fluid (sudden movement of the ventricle fluid through the ventricular system) during craniocerebral injury, changes in intracranial pressure caused by the impact of external forces, cerebrovascular dysfunction, and mechanical pull or distortion of the brain stem. .

Traditional wisdom holds that concussion is only a temporary dysfunction of the central nervous system, with no visible organic damage. However, in recent years, studies have found that the mitochondria and axons of the stressed neurons swell, and the interstitial edema; the concentrations of acetylcholine and potassium in the cerebrospinal fluid increase, which affects the axon conduction or the enzyme system of brain tissue metabolism. Clinical data also confirm that brain stem auditory evoked potentials in half of patients with concussion suggest organic damage. Some scholars have suggested that concussion may be the lightest diffuse axonal injury.

1. Disorder of consciousness: it is mild and short-lived, it can be as short as a few seconds or minutes, but not more than half an hour.

2. Forgotten recent events: After sobering, you can't recall the situation and the course of the injury, but you can clearly remember the events before the injury.

3. Other symptoms: headache, dizziness, nausea, anorexia, vomiting, tinnitus, insomnia, photophobia, lack of concentration and unresponsiveness.

4. No positive signs of neurological examination.

Intracranial pressure in lumbar puncture is normal, and some patients may have lower intracranial pressure. Cerebrospinal fluid is colorless and transparent, contains no blood, and has a normal white blood cell count. Biochemical examinations are mostly in the normal range, and some can detect a significant increase in acetylcholine content, reduced cholinesterase activity, and increased potassium ion concentration.

Skull x-ray

No fracture was found.

2.Cranial brain CT scan

There were no obvious abnormal changes in the skull and intracranial.

3. EEG examination

The EEG was mostly normal in the months after the injury.

4. Cerebral blood flow test

Cerebral blood flow may be reduced early after injury.

1. A short-term coma occurs immediately after a head injury. The time is within 30 minutes. After awake, there are symptoms such as amnesia, headache, dizziness, nausea, anorexia, vomiting, tinnitus, and inattention. Blood pressure, breathing, and pulse are basically the same. normal.

2. The neurological examination showed no positive signs. Lumbar puncture examination showed normal cerebrospinal fluid pressure and composition.

You can observe in the emergency room for a certain period of time after the injury, and pay close attention to changes in consciousness, pupils, limb movements and vital signs. If secondary intracranial lesions or other complications are found, timely diagnosis and treatment can be obtained. Patients with acute concussion should pay attention to bed rest, avoid external stimuli, reduce mental activity, give appropriate sedation and improve autonomic nerve drug treatment, and pay attention to patients' psychological regulation and treatment.

Most patients returned to normal within 2 weeks and recovered well.