How to recover from a concussion. Principles of rehabilitation after a concussion

In recent years, the brain-body connection has been seen as a powerful factor in influencing health. Studies of the relationship between stress and health status show that meditation can affect many aspects of health and athleticism, including the production of performance-related hormones such as testosterone and growth hormone.

Now another aspect of the brain-body connection has become clear. Student-athletes are almost twice as likely to suffer knee, ankle and lower body injuries if they had a concussion in the previous year, according to a new study. Scientists at the University of North Carolina came to this conclusion by analyzing data from 44 athletes from a variety of sports, including American football, basketball, field hockey, football, who were diagnosed with concussions and comparing them with data from control athletes who did not have concussions. .

The results showed that athletes who survived a concussion were 1.6 times more likely to have lower body injuries during the year after a concussion than athletes in the control group. The researchers wanted to find out if these athletes had a propensity for injury, so they compared the injury rates of the subjects before and after a concussion. They found that within a year of a concussion, athletes were almost twice as likely to have lower limb injuries than before.

Scientists believe that the concussion could impair the brain's ability to coordinate movements. Following a concussion, both short-term and long-term disturbances in gait and balance were noted. A change in movement patterns causes disturbances in the biomechanics of the body, in which the ability to transfer force from side to side and from the upper half of the body to the lower half can change. This increases the risk of injury at high speeds. In addition, it is believed that small disturbances in the metabolic mechanisms of the brain increase the interval between the reaction of the brain and movement.

Perhaps the most disturbing finding is that the deterioration seen in athletes after a concussion can last for up to a year, and possibly longer. These studies have shown that 85 percent of athletes after a concussion return to sports within seven days, that is, long before the full restoration of brain mechanisms and the return of biomechanics to normal.

So how can the risk of injury to the lower half of the body be reduced in those who have suffered a concussion?

Naturally, the first step is to work with sports medics who have the necessary experience in concussion recovery. These studies show that the recovery process in athletes is extremely variable and needs an individual approach. It should be noted that recovery takes longer for young athletes than for adults. In addition, new data shows that there are several strategies that can speed up recovery after a concussion.

Creatine intake

Every time a concussion occurs, athletes experience a decrease in creatine levels. This results in the production of reactive oxygen species and triggers oxidative stress, which causes a host of neuromotor problems, including decreased brain function and impaired coordination. Preliminary research has shown that creatine may have a neuroprotective effect, reducing the negative effects of reduced blood flow to the brain as a result of a concussion. Animal studies have shown a 50 percent reduction in cortical damage. While there has not yet been a human study of this effect of creatine, taking as little as 5 grams per day improves coordination, memory, and reaction time in athletes with sleep disorders.

Start practicing vigorous physical activity as early as possible

Data from a recent study conducted at McMaster University, Canada on young athletes who suffered from a concussion showed a positive effect of intense exercise on a stationary bike to fatigue. Scientists were surprised to find how much improved the condition of the athletes after the test. Improvements were observed within 24 hours after training. This means that the intensive sports protocol provides athletes with a double benefit during the recovery period.

First, it is a relatively safe diagnostic test to assess an athlete's readiness to return to training without putting them at high risk of injury. Pedaling a bicycle eliminates jumping or running, which is typical of team sports, which carry an increased risk of injury during periods of declining motor function. Second, exercise can improve health and speed up recovery. These data are preliminary, and scientists advise training under the supervision of sports medical personnel for a prompt assessment of the state of health and the recovery process.

Avoid overtraining

A negative side effect of a concussion is the need for prolonged rest, which leads to detraining. Upon returning to regular training, athletes often experience symptoms of depression and an increased risk of injury, which is associated with a decrease in strength, tone and muscle mass. Naturally, rest is needed in the period immediately following a concussion, but according to scientists, prolonged rest for concussion patients for more than a few weeks is unlikely to be helpful.

The challenge is to determine the right level of training intensity. Scientists recommend simple conditioning and strength exercises that do not involve complex movements that are associated with an increased risk for the joints at a time when coordination of movements has not yet recovered.

Conclusion

No athlete wants to be excluded from sports due to a concussion. Careful supervision by the coach and sports physicians is necessary for reliable recovery and avoiding serious injuries during the period when the athlete is vulnerable. While it is still necessary to establish an ideal activity level, preliminary evidence suggests that creatine supplementation and appropriate exercise can speed up recovery and help avoid decompensation and depression.

Primary sources:

Dematteo, C., et al. Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion. Medicine and Science in Sports and Exercise. 2015.47(11):2283-90.
Lynall, R., et al. Acute Lower Extremity Injury Rates Increase after Concussion in College Athletes. Medicine and Science in Sports and Exercise. 2015.47(12):2487-92.
Pietrosimone, B., et al. Concussion Frequency Associates with Musculoskeletal Injury in Retired NFL Players. Medicine and Science in Sports and Exercise. 2015. 47(11):2366-72.
Freire, R., Cassol, G. The effects of creatine supplementation and physical exercise on traumatic brain injury. Mini Reviews in Medicinal Chemistry. 2015. Published Ahead of Print.
Cook, C., et al. Skill Execution and Sleep Deprivation: Effects of Acute Caffeine or Creatine Supplementation. Journal of the International Society of Sports Nutrition. 2011.8(2).
Vagnozzi, R., et al. Decrease in N-acetylaspartate following concussion may be coupled to decrease in creatine. Journal of Head Trauma and Rehabilitation. 2013.28(4):284-92.

A concussion (etymology: comes from the Latin “commotio”) is the mildest of all variants of brain (and skull) injury, occurring without (macroscopically) visible damage to the brain structure, manifested by impaired brain function, decreased performance.

The most common cause of a concussion is a fall - most often in winter with icing - and a blow to the head, domestic fights, injuries at work, injuries during sports (especially impact sports). Recovery after a concussion is faster and more complete than after concussion and other severe TBI. A concussion of the brain requires hospitalization in a neurological or neurosurgical hospital.

In order to reliably speak about a concussion, in addition to the fact of an injury, it is necessary to have a triad of signs or one of them:

Loss of consciousness (absence for a few seconds or minutes). The longer there is no consciousness, the more severe the trauma and consequences. Retrograde amnesia (the patient does not remember the moment of injury, the circumstances of the injury, the immediate time before and after the injury is “erased” from memory). Subsequently, the memories return. Vomiting ("cerebral", not bringing relief), headache, noise in the head, painful movements of the eyeballs, sleep disturbances. 1-2 weeks after the injury, the symptoms regress, the patient's condition improves. Lack of improvement may be a sign of organic pathology in the brain. Lability - emotional, vegetative - lasts up to a month or more.

Learn about the late signs of a concussion: how not to miss the worsening of the patient's condition.

Why do complications occur after a concussion? Causes of pathology.

When examined by a neurologist, the following can be detected: nystagmus (horizontal), increased reflexes from the tendons, symptoms of meningism (not always detected, if present, they usually disappear after a few days during the recovery period after a concussion of the brain): Brudzinsky, Kernig, stiff neck muscles.

Anisocoria is an unfavorable sign indicating the likely presence of a contusion focus in the brain (i.e., anisocoria is more characteristic of brain contusion, but can also occur with concussion).

Focal changes (loss of sensitivity, paralysis and paresis, decreased strength) are not detected. In the study of cerebrospinal fluid (during lumbar puncture), no hemorrhagic and other impurities should be detected. CSF pressure may be elevated.

To exclude damage to the bones (vault, base of the skull, facial skeleton), an x-ray of the skull is performed. To exclude probable organic changes, CT (MRI) of the brain or ultrasound imaging is performed in order to exclude the displacement of median structures. This should not reveal the following:

Subdural hematoma (various volume). epidural hematoma. Parenchymal hematoma. Subarachnoid hemorrhage (SAH). The focus of contusion (hypodense, caused by the presence of detritus - dead organic matter). The focus of contusion is mixed (detritus and blood). Breakthrough of blood into the ventricles. Dislocations and compression of brain structures. Deformation and compression of the ventricles of the brain. Fractures of the bones of the skull.

When any of the listed conditions is detected (except, perhaps, the last one - skull fractures are not always accompanied by changes in the brain parenchyma, hemorrhages), it is no longer a concussion, but a brain contusion - a more serious condition that requires hospital care and, possibly, neurosurgical interventions (for example, ventricular puncture to aspirate contents, opening and draining a hematoma).

Depending on the severity of the damage, the brain recovers at different times. With a mild injury, a few days are enough for the symptoms to disappear completely. In more severe cases, recovery is long, treatment in a hospital is necessary. During rehabilitation, they follow the principles that will allow you to recover faster after a concussion of the brain, to minimize possible complications:

Peace, silence, horizontal position, lack of physical, mental, emotional stress during at least an early recovery period. Treatment in a hospital setting. To reduce the severity of pain, analgesics, NSAIDs (pentalgin, ibuprofen, etc.), sedatives, tranquilizers (as prescribed by a doctor) are indicated. To reduce the severity of violations of brain functions - vascular (stugeron, cavinton) and metabolic agents, nootropics (picamilon, piracetam, phenibut). Appointment of general strengthening agents (eleutherococcus, vitamins).

Do you know what happens during a concussion in the brain? Typical signs of trauma.

Concussion Misconceptions: 9 Common Myths.

Proper nutrition for concussion: diet, diet, allowed and prohibited foods.

It is not recommended to self-prescribe any drugs for suspected concussion. After any TBI, it is necessary to consult a doctor (traumatologist, neurologist), undergo a CT scan (MRI) of the head in order to identify possible organic changes in the brain, exclude more severe pathology - brain contusion, hematomas (parenchymal, sub- and epidural), SAH. In the case of timely detection of complications, early treatment, it is usually easier to recover quickly after a concussion than in the case of untimely assistance.

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Restoration of the body after a concussion is a rather long and complex process, which is necessary for everyone who has suffered from this injury to go through in stages, so that in the future there will be no complications and negative health consequences.

The fact is that medicine classifies concussion as a mild head injury, but without proper treatment and rehabilitation, it can lead to very serious consequences, up to chronic nervous and mental diseases.

A concussion is a blunt trauma to the head that causes neuronal dysfunction but does not damage the medulla or blood vessel system in the brain.

As a rule, a concussion is assessed by forensic experts as causing minor harm to human health, however, with improper treatment, this harm can be both moderate and severe, up to disability and disability.

This injury is diagnosed by a neurologist and a traumatologist, if necessary, a neurosurgeon can be involved for these purposes. For a correct diagnosis, it should be clearly defined that in a particular case there was definitely no head injury in the form of a brain contusion.

A brain contusion is an injury that causes much more serious harm to health, and therefore requires a different, more serious treatment and longer rehabilitation measures.

To rule out a brain injury, a patient is treated with radiography, computed tomography (CT), MRI, EEG, neurosonography, and other methods of brain research are used.

After confirming the diagnosis - concussion - the patient undergoes a full course of medical procedures as prescribed by the attending physician. At the same time, the neurologist almost always prescribes strict bed rest and complete rest to his patient. It should be noted that it is with this that recovery begins, the rehabilitation of his brain after the injury.

As a medical treatment, drugs are prescribed that promote, improve the functioning of the brain and blood vessels in it, as well as drugs for symptoms: painkillers, diuretics, sedatives, sedatives and other means.

The duration of treatment for an adult, as a rule, lasts about two weeks, and for a small child - at least a month, after which they fit in from the inpatient department home, where they must continue all the rehabilitation measures prescribed by the attending physician.

Rehabilitation after a concussion has the following goals:

General strengthening of the body. Counteracting asthenic syndrome. Adaptation of the victim to physical activity. Improving the stability of the vestibular apparatus. Counteracting relapse, return of symptoms. Counteracting the appearance of more severe pathologies against the background of concussion.

Rehabilitation is a whole complex of activities that are carried out both during the period of treatment and in the subsequent period of recovery of the body. As a result, the patient must fully restore his skills and compensate for the negative consequences of the injury.

At the earliest stages of concussion treatment, on the second day, the patient should master the beginnings of physiotherapy exercises: make passive movements, do simple breathing exercises in a supine position.

At the end of bed rest, the patient should continue daily exercise therapy (LFK) and breathing exercises. It is important not to overdo it here, because at this time the patient is prescribed complete rest, i.e. his brain should not be overstrained, and the person himself should not become emotionally excited. Therefore, all physical exercises should be done under the supervision of a specialist. You can also start doing exercises aimed at strengthening the vestibular apparatus.

At the next stage of rehabilitation, about a month after the injury, you can move on to active physical exercises, the purpose of which is to restore, rebuild or compensate for the functions impaired as a result of the injury. At this time, you can start exercising on simulators and special rehabilitation stands. Daily training of the vestibular apparatus continues until it is fully restored.

First of all, remember that the whole complex of recovery procedures after a concussion should last at least a year. Secondly, always follow only the doctor's recommendations. Within a year after the injury, you will be registered with the dispensary, so you can visit a neurologist at any time for a consultation.

Throughout the year after a concussion, it is necessary to follow a therapeutic diet, consisting of foods and dishes that are easily absorbed by the body, so that it can focus its efforts solely on restoring normal brain activity after a concussion.

Also, throughout the year, you should not drink alcoholic beverages, because. even in small doses, they have a detrimental effect on still fragile brain cells. It is also necessary to limit yourself in every possible way in the use of strong coffee, tea and other stimulating drinks.

After leaving the hospital, be sure to take a long vacation from work and spend it in a quiet countryside, away from the city, which is too noisy and poisoned by industrial waste. Eliminate any stress from your life, incl. Watch less television and surf the Internet.

It is likely that during the year you will be tormented by insomnia, but do not abuse sedatives, sedatives and tranquilizers, take them strictly according to the doctor's prescription or with his permission.

If suddenly, months after the concussion, your vision has sharply decreased, dizziness, nausea, vomiting, sleep has disappeared, immediately contact a neurologist and do not forget to remind him of the date when you had a concussion so that the doctor can timely and correctly put diagnosis and appropriate treatment.

Ask a question to a specialist

A concussion (CMH) is a pathological condition that occurs as a result of a mild traumatic brain injury. Takes first place among its species. The frequency of this pathology is 3-4 per 1000 population. The causes of TBI can be varied. Often these are injuries received at home, at work, as a result of traffic accidents. Brain damage is one of the main causes of death and disability in patients.

The SGM is characterized by the following features:

short-term depression of consciousness (stunning or stupor lasting several minutes, and sometimes seconds); amnesia for a short period of time; nausea, single vomiting; increased blood pressure; increased breathing and heart rate; pallor of the skin, which is replaced by hyperemia; dizziness, headache, tinnitus after recovery of consciousness; insomnia; general weakness, sweating; pain when moving the eyeballs, their divergence when trying to read something; expansion or contraction of both pupils; asymmetry of tendon reflexes; small horizontal nystagmus; mild meningeal symptoms (disappear within a week).

The general condition improves rapidly, after 1-3 weeks only asthenic phenomena remain. Sometimes headache or other symptoms last longer.

Loss of consciousness and other neurological symptoms are due to the disintegration of nervous activity, a violation of the interaction between the cerebral cortex and its other structures.

In young children with this pathology, loss of consciousness often does not occur. After the injury, there is a sharp pallor, increased heart rate, lethargy and drowsiness, regurgitation or vomiting. The child becomes restless. In preschool children, there is a horizontal nystagmus, hypotension, subfebrile temperature. Within 2-3 days the condition is normalized.

In people of senile and elderly age, the disease has its own characteristics. More often than in young people, there is a loss of consciousness and amnesia, disorientation in space and time, more intense headaches and dizziness. Clear focal symptoms may be detected, which may be mistakenly regarded as a more severe pathology. Often, after an injury, patients develop an exacerbation of chronic diseases of the heart and blood vessels, diabetes mellitus, etc. Recovery proceeds at a slower pace.

These symptoms usually go away after a while without further treatment.

Recognition of a concussion can be difficult, as it is manifested mainly by subjective symptoms. It is important to take into account the fact of injury and loss of consciousness, often from the words of witnesses to the incident. If the diagnosis is difficult to confirm due to the presence of a chronic cerebral pathology in a patient, then the rapid disappearance of symptoms may be informative. The specialist conducts an examination and prescribes an additional examination to exclude more severe brain damage:

radiography (fractures of the bones of the skull are absent); electroencephalography (M-echo is not shifted); examination of cerebrospinal fluid (composition is not changed); computed tomography (does not detect changes in the substance and ventricles of the brain); MRI (does not reveal focal pathology).

The priority in treatment is first aid. If a person is unconscious, you need to lay him on his right side, in the presence of wounds - carry out treatment and apply an aseptic bandage. All patients with TBI should be hospitalized in a hospital, as the condition improves, they can be discharged for outpatient treatment. In the first three days, patients need bed rest, followed by its gradual expansion. To restore the normal functioning of the body, patients need rest, healthy sleep and good nutrition. Treatment is symptomatic.

The main drugs prescribed for SGM:

analgesics (ibuprofen, nimesulide, maxigan, etc.); sedatives based on medicinal plants (valerian, motherwort) and tranquilizers (adaptol, afobazole); sleeping pills (relaxon, donormil); nootropic (nootropil, glycine); tonic (ginseng, eleutherococcus); drugs that improve cerebral circulation (cavinton, sermion, piracetam); magnesium-containing products (magne-B6).

Physical methods of treatment complement medication, improve cerebral circulation and metabolism.

The main methods of physiotherapy used to treat concussion:

drug electrophoresis with vasodilators and stimulants of brain metabolism; galvanization of the brain and segmental zones; transcerebral UHF-therapy; laser therapy; aerotherapy; oxygen baths.

After 2 months from the onset of the disease, patients who have suffered a mild head injury can be sent to the climatic and balneological resorts of Kislovodsk, Pyatigorsk, Essentuki, Solnechnogorsk, etc. Also, recovery can be carried out in local-type sanatoriums. Spa treatment is not prescribed in the acute period after an injury, in the presence of general contraindications, mental disorders.

A concussion occurs with minor mechanical injuries. A fairly common pathology that occurs in every 3-4 citizens out of 1000. The occurrence of an injury can be associated with household chores, professional activities, or with a car accident. The course of treatment is long, recovery after a concussion occurs gradually. The rehabilitation period can take from several weeks to several months.

Symptoms of the disease are easy to identify and correlate with the cause.
Develop:

depression of consciousness from several minutes to several hours;
short-term loss of consciousness;
nausea;
hypertension;
tachycardia (heart rate more than 100-120 beats / min);
dizziness;
soreness in the occipital region or on the head;
sleep disturbance;
the occurrence of pain discomfort when reading or when looking closely at an object;
changes in pupils (dilated / narrowed);
asymmetric reflexes on the upper and lower extremities;
symptoms of meningitis.

In this case, weakness, lethargy, disorientation in space, disruption of synaptic connections between the cortex and brain structures can occur.

Concussion in children and adolescents

For children of the preschool period, short-term fainting with memory loss for several minutes is characteristic. Children experience blanching of the skin, heart rhythm disturbances in the form of a palpitation sensation, fatigue, gag reflex and regurgitation. The child cannot sleep because of the constant headache and cries all the time. Some preschoolers develop horizontal-type nystagmus, hyperthermia, and high blood pressure. After a few days, the child's well-being improves, the symptoms subside or disappear completely.

Concussion in the elderly

In senile and presenile ages, pathology has its own distinctive features. Patients suffer from prolonged loss of consciousness and memory, lack of orientation in time and location, combined with sharp frequent headaches. In addition, the elderly often experience circulatory disorders such as ischemic strokes, the transition to the phase of exacerbation of pathological conditions of the heart, and the aggravation of the course of endocrine pathologies. The duration of recovery is increased.

Diagnosis of the disease is carried out in the first hours or even minutes after the incident. After confirming the diagnosis, a thorough medical care is provided by a neurologist, depending on the indications. The course of therapy is selected individually for each patient.

Recovery after a concussion

After a course of conservative therapy, restorative rehabilitation measures are prescribed that improve the general condition, normalize the functioning of the brain and other parts of the nervous system.

Rehabilitation after a concussion consists of complex measures aimed at the recovery of patients. It includes:

therapeutic physical culture;
medical gymnastics;
breathing exercises;
massage;
physiotherapy procedures.

The rehabilitation process is divided into 4 periods:

elementary;
intermediate;
late recovery;
residual events.

Initial period

In the initial period, which begins on the 3-5th day, it is forbidden to engage in any physical activity. Movement should be limited. Use gymnastic passive exercises and breathing exercises. All exercises are performed in the supine position.

The tasks of physiotherapy exercises in the initial period are:

restoration of the mental status and psychological aspects of the patient;
prevention of the development of complications provoked by traumatic agents;
restoration and stabilization of the work of vital organs, especially cardiac activity and the respiratory system;
prevention and treatment of hematomas in the brain.

Therapeutic exercises with a slight concussion begin to be carried out in the first days, even if the patient is in the intensive care unit. When the patient is stabilized, there is no nausea and headache, he is given a semi-sitting position and special exercises begin. If the patient's condition is moderate or severe, the exercises are carried out in the "lying" position.

At the initial stage, exercises are used for the muscles of medium and small groups. Involves the muscles of both the upper and lower extremities. Exercises are carried out slowly, the number of repetitions is reduced. It is recommended to carry out exercises several times a day (3-5 times) for 5-10 minutes. This will prevent complications and not burden the patient's body.

The main exercises include:

squeezing and unclenching fingers and toes;
flexion and extension in the elbow joints;
slow tilts of the head to the sides.

Breathing exercises play a huge role. But with hyperventilation, tissue hypoxia of the brain can develop and provoke violations of the functions of the lungs and the hypothalamic-pituitary system.

You can not hold your breath, take deep breaths with an extended exhalation. When performing breathing exercises, the number of repetitions is not more than 4.

If there is a loss of skin, temperature or pain sensitivity or its decrease, the patient must be taught to transmit impulses through motor neurons.

In the initial period, to prevent the development or eliminate the resulting hematoma, a therapeutic massage is performed. The neck area is carefully massaged using a special technique. This massage causes the restoration of impaired blood persistence in the vessels of the brain and the resorption of the accumulated blood clot in the cerebral arteries.

Interim period

With craniocerebral injuries, when the patient begins to adapt to higher physical exercises, they move on to movements in large joints (shoulder, knee and ankle).

The intermediate stage begins. In order for the patient to take the “half-sitting” position, it is necessary to carry out a set of measures for this. It is forbidden to immediately force the patient to sit down, as there is a high risk of fainting or collapse. Exercises should be aimed at restoring vascular tone, eliminating the developed pathological reflexes. As they recover, patients perform therapeutic exercises of the initial period, which are joined by therapeutic exercises of the intermediate period.

If during concussion the functions of the flexor muscles of the forearm and hand, foot and leg extensors were impaired, it is necessary to oppose them to antagonist muscles. It is necessary to carry out exercises for flexion-extension of muscles in the shoulder, elbow, wrist, ankle, knee joints. Muscles should be in a relaxed state. You need to strengthen weakened muscles that have lost their functions.

You can not do exercises if the patient experiences pain during physical therapy.

Classes are held in combination with massage. It can be a point or local massage.

In case of impaired coordination, classes are used to restore the lost functions of the cerebellum. Using special objects, they improve the accuracy of coordinated movements in space.

In the second period, the patient is already in the ward of the neurological department. Clinical symptoms gradually subside, the patient can move around the territory of his department. Classes can be carried out in a lying or sitting position.

The patient needs to do:

tilting the head to the side;
torso to the right / left;
abduction and adduction of hands;
flexion and extensor movements in the joints of the upper and lower extremities.

It is also necessary to strengthen the vestibular apparatus. Carry out combined tilts of the head and torso in different directions. If the patient manages to make circular movements, then they are also recommended to be used.

The objectives of the second recovery period after a concussion are:

measures to restore walking;
maintaining balance and improving coordination;
memory stabilization.

When the patient is already strong and can get up, walking does not bring much discomfort, the patient needs to slowly develop the skill of walking.

First, special physiotherapy procedures are carried out: electrophoresis and foot massage. The doctor prescribes moderate dosed walking. (The doctor recommends that during the day he first walks 50 meters 1-2 times a day, for example, from the toilet to the ward or from the ward to the dining room, then eventually increases to 100 meters, etc.).

The duration of complex events in the second period is 30-45 minutes.

This time includes not only independent exercises, but also physical therapy measures carried out by a doctor.

late recovery period

In the third period, which is a late recovery period and is carried out a month after the concussion occurred, measures are taken to restructure and compensatory mechanisms.

Continue performing exercises from the previous complexes, preventing the development of cerebrovascular accident. These exercises are joined by exercises that are performed in the "standing" position. Tilts of the body are performed in different directions, in some cases touching the ground.

Exercises are performed to improve memory.

Residual or period of residual effects

During the period of residual effects, rehabilitation measures are aimed at eliminating the remaining consequences after a concussion has occurred.

Already begin to perform exercises with the help of special simulators and equipment. They use treadmills at a very low speed, exercise bikes, with slow exercises.

Prevention

Preventive measures are carried out after the patient is discharged from the hospital. The patient must comply with all the doctor's instructions so as not to aggravate his condition and not provoke the development of complications.

Complications of a concussion include:

prolonged headaches that are not stopped by painkillers (sedalgin, analgin, etc.);
frequent dizziness;
neurasthenia;
convulsive syndrome;
unstable psyche: a tendency to depression, irritability, lack of sleep and neuroses.

The doctor prescribes certain medicines:

analgesics - ibuprofen, nimesil;
nootropic drugs - piracetam;
tonic drugs - preparations of ginseng;
preparations containing macro and microelements - magnesium B6, calcium gluconate.

With prolonged bouts of depression and neurosis, a psychiatrist's consultation is necessary. Antidepressants, amitriptyline, are used to treat depression.

Patients need to avoid stressful situations, eat right and engage in therapeutic exercise. Bad habits should also be avoided. In some cases, patients develop an aversion to alcohol and cigarettes.

After treatment and rehabilitation after a concussion (in 1-2 months), the patient, if desired and possible, should be provided with sanatorium-and-spa treatment.

A concussion is a dangerous pathological condition that can lead to disruption of the functionality of the structures of the nervous system. It is necessary to immediately contact a specialist for medical assistance after a head injury has occurred. After that, certain methods of rehabilitation will be prescribed to restore lost functions. Performing all the exercises and prescriptions will help to fully restore the body and get rid of the clinical symptoms of a concussion.

The SGM is characterized by the following features:

The general condition improves rapidly, after 1-3 weeks only asthenic phenomena remain. Sometimes headache or other symptoms last longer.

Loss of consciousness and other neurological symptoms are due to the disintegration of nervous activity, a violation of the interaction between the cerebral cortex and its other structures.

These symptoms usually go away after a while without further treatment.

The main drugs prescribed for SGM:

Physical methods of treatment complement medication, improve cerebral circulation and metabolism.

The main methods of physiotherapy used to treat concussion:

drug electrophoresis with vasodilators and stimulants of brain metabolism; galvanization of the brain and segmental zones; transcerebral UHF-therapy; laser therapy; aerotherapy; oxygen baths.

Pathological changes in concussion are temporary and reversible. With timely seeking medical help, adequate treatment and adherence to the recommendations of the doctor, recovery occurs quite quickly with full restoration of working capacity. To prevent possible complications, such patients are observed by a neurologist for a year.

School of Dr. Komarovsky, issue on the topic "Concussion":

TVC, program "Doctors", episode on the topic "Concussion":

In order to reliably speak about a concussion, in addition to the fact of an injury, it is necessary to have a triad of signs or one of them:

Learn about the late signs of a concussion: how not to miss the worsening of the patient's condition.

Why do complications occur after a concussion? Causes of pathology.

Anisocoria is an unfavorable sign indicating the likely presence of a contusion focus in the brain (i.e., anisocoria is more characteristic of brain contusion, but can also occur with concussion).

Do you know what happens during a concussion in the brain? Typical signs of trauma.

Concussion Misconceptions: 9 Common Myths.

Proper nutrition for concussion: diet, diet, allowed and prohibited foods.

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Injuries to the skull that impair brain activity and damage its tissue vary in severity. Of all traumatic brain injuries, concussion is the mildest injury.

With a concussion, a temporary deterioration in brain functions occurs: the restoration of normal operation occurs on average after 5-10 days. However, any head injury, no matter how mild it may seem, can cause complications and consequences, and therefore require a medical examination.

The human brain is surrounded by a special fluid (liquor), which serves as a kind of shock absorber, and is protected from external influences by the cranial bones. A concussion occurs when the brain hits a bone suddenly.

The causes of a concussion can be different:

falls; head bruises; road accidents; injuries during sports; injuries during a street fight;

Depending on the strength of the impact, concussion can be light, medium and severe.

Of all childhood injuries, concussion is the most common. This is due to the increased physical activity of children, their lack of fear of heights and inadequate assessment of the possible danger.

In young children, the head is also heavier than in adults, so when it falls, it suffers first of all - children do not coordinate their movements well and do not know how to fall on their hands.

Infants get concussions as a result of parental inattention. Head injuries in childhood can lead to serious deviations in the intellectual and physical development of the baby. Competent and timely treatment will help to avoid negative consequences.

The characteristics of the child's body are such that the consequences of trauma are tolerated by children much harder than by adults. Infants may experience repeated vomiting and regurgitation. Preschoolers may experience loss of consciousness, unstable pulse, and in the future - whims, bad mood, sleep disturbances.

Traumatic brain injuries may not remind of themselves all life, but may manifest themselves in old age as serious problems.

A person may experience dyscirculatory encephalopathy of the brain, which can significantly worsen the quality of life.

In addition, after a concussion, a person can be tormented by constant headaches in the temples, why this happens can be found here.

Main symptoms:

loss of consciousness; nausea; dizziness; clouding of consciousness; amnesia; visual disturbances (even temporary blindness is possible in children); inhibited reactions; lack of appetite;

Some symptoms may not appear immediately after the injury, but after 12 or more hours.

An accurate diagnosis is made by a specialist, for example, a traumatologist. He examines the patient, checks his reflexes and conducts a survey, finding out the circumstances of the injury.

If a severe concussion or more serious injury is suspected, the patient is referred to a neurologist. He, in turn, appoints a comprehensive examination. Can be assigned:

radiography; electroencephalography; MRI (magnetic resonance imaging); echoencephalography; ultrasonic dopplerography; spinal puncture; CT scan;

The severity of the injury can be determined by the doctor using the Glasgow scale. To do this, various tests are carried out, the patient's reactions are checked and scores are set. Depending on the reactions and answers, the patient is awarded points (from 3 to 15). A concussion is diagnosed when more than 13 points are scored.

The conducted hardware studies, as well as palpation, observations and practical experience allow the doctor to find out whether there is a risk of complications and whether there is damage to areas located near the head - for example, the cervical spine.

After an injury, the patient should be under medical supervision. If the patient experiences pain, does not regain consciousness, faints, or his memory cannot be restored for a long time, he remains in the clinic for the next day or more - up to a week or two - until the situation is clarified.

Medicine classifies the following types of concussions:

1 degree (fainting, recovery of well-being within half an hour after the injury); 2 degrees (disorientation after regaining consciousness lasts longer than 30 minutes); 3 degrees (after losing consciousness, the patient does not remember what happened to him);

Let's find out what to do right after a concussion. If there is no qualified specialist nearby, you should not be afraid. Everyone is able to provide first aid until the ambulance arrives.

If you suspect a concussion, you should immediately call the emergency medical service and in no case leave the victim unattended: he may begin to vomit, convulsions, or worsen dramatically.

You need to put the victim on his back or on his side and do the following:

make sure that the patient has breathing and heartbeat; check and measure the patient's pulse; treat wounds, if any; apply cold; ask eyewitnesses about the circumstances and details of what happened;

If the patient is conscious and able to answer your questions, position the patient so that the upper body is on a slight elevation (eg, on a pillow).

In the absence of consciousness, turn the patient on his side. The position of the body must remain stable. It is desirable to darken the room, protecting the sight of the victim. In the event of a threat to the life of the patient before the arrival of the doctor, it is necessary to take resuscitation measures.

In the event of a child injury it is necessary to call for help and make sure that the victim is referred to a qualified neurologist. It is important that the child (if conscious) remains awake for at least an hour. Limit his physical activity. Do not give any medications, especially painkillers, until the doctor arrives.

To reduce the risk of childhood injury during games and sports, you should teach your child to follow safety measures - wear a helmet while rollerblading, cycling, skiing, skating and not playing in dangerous places without adult supervision.

Should a mild concussion be treated?

It is necessary to treat a concussion, even the mildest one. The therapeutic course is prescribed by the doctor depending on the severity of the concussion. The duration of treatment averages about 10 days. Of these, the patient was prescribed bed rest for 5 days.

If the concussion is mild, the patient can stay at home, but he should temporarily stop working and playing sports. In addition, it is better to limit or completely eliminate TV viewing, computer activities and long reading. It is necessary to observe the rest mode for several days, then physical activity should be increased - to normalize blood circulation in the brain.

A month after therapy, the victim should undergo a re-examination in order to make sure that there are no complications. The healing process will be faster if:

observe the daily routine; ventilate the room; sleep enough time; stop smoking; exclude alcohol, coffee and other stimulants; Do not also do household chores and drive a car.

The consequence of a head injury can be neuralgia of the occipital nerve, which must be treated.

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During the acute phase of concussion, in the presence of nausea and dizziness, the patient is prescribed antiemetics. In the future, he may be prescribed drugs that help normalize cerebral circulation.

First of all, these are sympathomimetics (drugs whose effects are similar to those of adrenaline). They stimulate the work of the autonomic nervous system, which regulates blood pressure, heart contractions, and bowel functions.

Head (especially occipital) intense pains are stopped by painkillers - non-steroidal antirheumatic drugs and other drugs that do not act on the nervous system. Sometimes tranquilizers are prescribed.

Herbal infusions can be used for a sedative effect, for example, tinctures of motherwort, valerian. Tinctures of thyme, aralia, St. John's wort are also used. Before using herbal infusions, just in case, you should first consult with your doctor. Alcohol tinctures should be used with great care to avoid overdose.

To prevent complications, the course of treatment must be completed in full and with the implementation of all the procedures prescribed by the doctor. For several days, with mild to moderate concussion, complete rest must be observed. Severe concussions should be treated in the hospital for 2-3 weeks.

It is better if complex methods of therapy are used, and along with drug treatment, physiotherapy is used (therapeutic exercises, contrast showers).

It is the most common traumatic brain injury. Despite many scientific and technological advances in medicine, head injuries today remain one of the main ones in terms of numbers, which are treated daily in a hospital or emergency room. Up to 90% of all diagnosed traumatic brain injuries are concussions.

With a concussion of the brain, treatment should be complete and take place under strict bed rest. The frequency of the consequences of this injury in the future depends on how successfully the treatment is carried out, at times. Therefore, the rule works here as well - it is easier to prevent than to cure.

Treatment

So, now in order: most often people with a concussion are delivered by ambulance to the emergency department of a nearby hospital, where a traumatologist, neurologist or neurosurgeon conducts an examination. After establishing the diagnosis, the patient is hospitalized in the department of traumatology or neurosurgery. In a hospital, the duration of treatment with this diagnosis is usually about 10-14 days.

The main method of treatment is medication.

Courses of anti-inflammatory drugs are prescribed to relieve swelling and relieve pain, most often they use a group of non-steroidal anti-inflammatory drugs (for example: ketorol, diclofenac, voltaren, ketonal, etc.). This is in case of severe pain and swelling of the soft tissues of the face or head.

The next group of drugs, which is one of the main concussion treatment are nootropic (neurotropic) drugs. They are called nootropics because their action is aimed at maintaining nutrition and metabolism in nerve cells. The group of drugs, in turn, is divided into other types according to their mechanism of action, we will not dwell on their designation in more detail, but we will list the main drugs that are used for concussion.

Piracetam or nootropil is a drug that has been used for decades in the neurotropic therapy of brain injuries. Its main advantage today is its cheapness, in comparison with other, newer and more modern drugs, so it is often used in public hospitals.

Other drugs belonging to this group are cinnarizine, glycine, picamilon, pantogam, pantocalcin, etc. Of the newer and more modern ones, gliatilin or cerepro, ceraxon, cerebrolysin, cytoflavin, etc. are used. The course of taking any of the above drugs is most effective if taken in the right dosage and the right duration.

With a high probability of increased intracranial pressure, diuretics or diuretics are used. For this purpose, diacarb, furosemide, potassium preparations, etc. can be used for traumatic brain injuries.

Vitamins of groups B and C are necessary to maintain metabolic processes in the cells and blood vessels of the brain and maintain their vital functions.

In a hospital or clinic, sometimes, in addition to drug treatment, physiotherapy is also prescribed. The range of physiotherapeutic methods is diverse and a physiotherapist will help to prescribe the optimal one.

Consequences

It is a relatively mild traumatic brain injury. It is believed that concussion disrupts the functions of nerve cells and centers that maintain the integrity of brain structures. When performing an MRI or CT scan of the brain, no changes in the substance of the brain are detected, and dysfunctions are transient.

If during a brain injury, intracerebral post-traumatic hematomas, loss of neurological functions may remain, which you can read about in more detail, then this, as a rule, does not occur during a concussion.

The consequences of a concussion are rarely serious, capable of leading to disability, although such cases also sometimes occur.

One of the consequences of a concussion is a headache. Headache is often present in the first days after the injury, then disappears with full and timely treatment. However, in rare cases, people report an increase in headache after suffering a concussion.

The next consequence is sleep disturbance. After a traumatic brain injury, sleep can be disturbed, it becomes intermittent and restless, up to insomnia, and sometimes manifesting itself in the form of nightmares.

Another of the long-term consequences of a concussion of the brain may be disorders of the autonomic system. After months, there may be changes in the emotional sphere, accompanied by palpitations, excessive sweating, and sometimes panic attacks. Panic attacks are manifested by a sudden feeling of unmotivated fear, which is painful for some people and significantly reduces the quality of life.

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