How to tell if you have a head concussion

Concussion is considered the most common type of traumatic brain injury. And it accounts for about 80% of all skull injuries. This injury in itself does not cause structural macroscopic changes in the brain. The disorders that occur during a concussion are purely functional and do not pose a danger to the life of the victim.

The Yusupov Hospital provides professional treatment for such injuries.

When to ask for help

After a head injury, a person should be examined by a doctor.
Even if there is no visible damage to the skull, the brain could be severely damaged. The doctor must rule out hemorrhage or swelling of the brain (these are more complex consequences of injury). Concussion symptoms fall into several categories because the injury affects almost the entire body.

1. The person lost consciousness for several seconds or minutes.
2. He doesn’t remember what happened to him and what happened immediately after the injury.
3. Inhibited, slow to answer questions, does not understand what is being said to him.
4. Can't concentrate.
5. Has difficulty reading or writing.
6. Cannot remember new information.

1. Headache.
2. Visual impairment: flies fly before the eyes, the image doubles and blurs.
3. Nausea and vomiting.
4. Dizziness.
5. Sensitivity to bright light and noise.
6. Balance problems, unsteady gait.
7. Drowsiness or, conversely, insomnia.

1. Unreasonable irritability.
2. Depression.
3. Increased emotionality: a person’s mood changes quickly.
4. Fatigue, lack of energy.

You can notice a child’s injury if his behavior has changed: the baby does not respond to external stimuli, cannot concentrate, is capricious, cries, and refuses water and food.

If a person who is drunk or taking tranquilizers is injured, he must be taken to the emergency room, because the symptoms of a concussion in such a situation are easy to ignore.

Symptoms after a blow

It is worth taking a close look at any person who has been injured and received a head injury, because even a seemingly insignificant blow can turn out to be critical.

The main signs of a concussion in most cases look like this:

• headache (almost always severe and throbbing);
• noise in ears;
• temporary confusion;
• fear of light and noise;
• nausea;
• vomiting (usually one-time);
• double vision;
• weakness;
• dizziness (which is present even at rest, and only intensifies with changes in body position or movement).

Depending on how a concussion manifests itself, the severity is determined by:

1. Mild concussion. The patient's consciousness is not impaired, but short-term disorientation may occur. Some victims faint, feel headaches and dizziness. What is typical is that when a mild concussion is diagnosed, the symptoms disappear 20 minutes after the injury.
2. Moderate severity. With this problem, disorientation lasts longer than 20 minutes. Victims, as a rule, do not lose consciousness, but complain of headaches, nausea, and dizziness. Some people, due to short-term amnesia, forget the moment of injury and do not fully understand where they got the signs of a concussion.
3. Severe degree. With such a concussion, victims inevitably lose consciousness - some for a couple of minutes, others for several hours. The person does not remember anything about the incident, and the main symptoms bother him for at least two weeks after the incident.

Check to see if the person is okay, preferably immediately after he or she is injured. How to diagnose a concussion? Often you can determine the problem simply by talking to the victim. At the same time, no sudden movements or vigorous activity should be carried out around it, so as not to aggravate the situation if a concussion is actually present.

To understand whether a person who has been injured has a concussion, it is necessary to analyze his condition.

In a medical institution, first an acquaintance with the situation takes place. The doctor listens to how and when the injury occurred and studies the patient’s medical history. Only then will the symptoms of a concussion be assessed. A neurological examination helps confirm or refute the diagnosis, during which a specialist asks questions and observes the victim’s reaction.

Tests that assess the patient's mental abilities are effective. They test memory, the ability to perceive and recall information, and concentration. Another standard test is a computed tomography scan. The procedure provides an image of the skull and brain and clearly shows if any changes have occurred in them.

Despite the extensive list of the main manifestations of a concussion, sometimes such an injury remains underestimated. After all, it happens that several hours or even days pass from the time of receiving a blow to the appearance of true signs. Therefore, immediately after an injury you should pay attention to the following symptoms:

• dizziness;
• tinnitus;
• nausea, vomiting;
• headache in the occipital area, increasing with sudden movements;
• pupils of different sizes;
• lethargy, drowsiness;
• fainting.

Since a concussion is a mild, but still traumatic brain injury, the victim should not self-medicate, and at the first signs of a disorder in his functioning, he should seek qualified medical help.

In general, children are very mobile by nature; they rarely avoid injuries and falls, which cause TBI. The parents’ task is to protect the baby as much as possible from serious injuries, so that he does not have to be sick for a long time or fight for life. The signs of a concussion in a child differ in some respects from adult TBI. In addition to the symptoms listed above, children have an increased tendency to whims, and sleep may be disturbed.

Only an experienced pediatrician or pediatric surgeon can determine damage inside the head in newborns, the parameters of which are slightly different from usual. Loss of consciousness in infants is rare, but regurgitation becomes more frequent, regardless of feeding time. The skin of an infant's face becomes paler than usual, and cold sweat may appear.

Prolonged crying of a baby, restlessness, sleep disturbance with sudden awakening - these are all possible symptoms of a concussion in infants if there is a suspicion that the baby hit his head. In case of serious brain damage, it is visually noticeable that the fontanel is swollen. The temperature of a small child rises sharply, and the pupils of the eyes are in chaotic movement, with a blurred look.

The main symptoms of mild traumatic brain injury, by which the doctor determines the diagnosis, mostly remain the same as for moderate severity. After receiving a blow to the head or under other circumstances, you need to undergo an examination. The absence of visible signs does not mean that the injury has passed without a trace.

• your head suddenly begins to feel dizzy;
• there is a loss of coordination of the surrounding space;
• nausea ends with vomiting;
• there is no clarity in the image of objects in front of the eyes, the appearance of a veil, spots, flashes interferes with the visual vision;
• slight pallor of the skin;
• no appetite;
• throbbing pain in the head, mild tinnitus;
• weakness with profuse sweating;
• unstable pulse.

How to get a concussion

Knockout in boxing

The easiest way is to call a boxer friend with a good knockout punch.

A concussion usually occurs during a swing, less often during a direct blow, and even less often during an uppercut to the chin.

However, if someone wields a knockout uppercut, such a blow will almost certainly cause a concussion, since the design of the head is not naturally designed to withstand blows from below.

When using an uppercut, you need to put on a mouthguard - otherwise you can split your teeth. But such boxers are rare; it will be easier for him to hit a direct or side blow to the cheekbone. There are good side strikes with the “teisho” plane - the base of the palm. They are more likely to cause a concussion than a fist, but few people wield them.

It is advisable to avoid blows to the temple - without gloves, a 3-4 mm thick bone can be broken even with a not very strong blow. Ask your partner to hit the cheekbone. For a good blow, he will need to stand for several seconds. It is useless to hit him in the forehead - the blow will be absorbed; the design of the head resists such blows best of all. In other parts of the head from above, in the back of the head - just as dangerous as in the temple.

Punch in the face

The safest thing is a blow to the face, but there is a risk of not only getting a concussion, but also a fracture of the upper or lower jaw.

On the other hand, a hematoma on the face will be evidence that a concussion was received.

A blow to the nose will also bring nothing but bleeding and a broken nose.

The second way is to get a concussion at home from a fall.

The problem is that a person will reflexively stop himself from falling and hitting his head on the floor.

Therefore, you will also need a partner. The sequence of actions is as follows:

• Free up space in front of you on the floor near a wall or cabinet - God forbid you get caught with some dumbbell or metal nut on the floor.
• The floor must be wooden - otherwise there is a risk of serious damage.
• You need to squat down near the wall and prepare a thick, wide scarf or belt.
• Take twenty to thirty deep breaths.
• Stand suddenly near the wall - the partner immediately takes a thick scarf and presses his neck against the wall.
• Consciousness will begin to disappear.
• Until the legs completely give way and the body slides smoothly down, the partner must jerk the body around, put on the step and forcefully throw the back of his head on the floor.
• There will be no pain when falling; consciousness, if everything is in order, should return in a minute.

In this case, the situation is safer than with a punch to the back of the head, since the blow falls over a larger area.

Dangerous ways:

• Jumping from a height onto your feet, which are spread slightly wider than your shoulders onto the asphalt, can seriously damage your knees.
• A blow with a heavy object, a stack of books, a plastic bottle with water or a piece of wood - the force of the blow is unpredictable; if hit with full force, the pain can even split the skull.

The stupidest thing you can do is to tell the military registration and enlistment office with a satisfied smile that you got a concussion on purpose so as not to serve in the army. According to the law of the Russian Federation, evasion of military duty by self-mutilation is punishable by imprisonment for up to 8 years.

Degree of damage

They are determined depending on the severity of the injury and its clinical manifestations. There are three types of concussion:

1. Light damage. It is not accompanied by impairment of consciousness. The patient may experience disorientation in space. Dizziness, cephalalgia, and nausea with a mild concussion usually disappear within a quarter of an hour after the injury. In some patients, the temperature rises to 37-38 degrees. However, the general condition of the patients quickly returns to normal.
2. Medium damage. With this pathology there is no loss of consciousness. But the main symptoms (dizziness, cephalalgia, nausea, disorientation) do not disappear within a quarter of an hour. Short-term memory loss is possible. As a rule, it is expressed in retrograde amnesia (the patient forgets events that occurred a few minutes before the injury).
3. Severe concussion. Accompanied by fainting. Loss of consciousness can be either short-term (within one or two minutes) or long-term (up to several hours). The patient experiences memory loss (a type of retrograde amnesia). Symptoms characteristic of a head injury bother the patient for two weeks after the injury. Fatigue, sleep disturbances, lack of appetite, and disorientation are observed.

How to recognize a concussion? It should be remembered that any, even minor, bruise or blow can lead to this damage. Therefore, if such an event occurs, it is necessary to carefully monitor the person’s condition. If symptoms of pathology occur, you should consult a doctor.

How to fake a concussion

The main brain symptoms that you need to know when simulating:

• Retrograde amnesia - the patient does not remember the moment of the concussion, as well as what happened immediately before it.
• Headache – constantly, for a long time.
• Nausea and vomiting - immediately after a concussion.
• Red eyes.
• Impaired knee reflexes are almost impossible to simulate.
• Violation of the reaction to light - is achieved by instilling a small amount of belladonna drops into one eye, nothing needs to be dripped into the other.
• When the eyes move to the side, they show symptoms of strabismus - some people know how to do this, but if you can only close your eyes when looking at the tip of your nose, it’s better not to.
• The patient does not hit the tip of the nose with his finger with his eyes closed.
• When asked to stand on one leg, stretch your arms forward, you just need to start falling. The doctor will most likely be able to catch it.
• Sleep disorders – excessive sleepiness or, on the contrary, insomnia. You can fake it if you really don’t sleep for a day before calling a doctor. Drowsiness can be simulated by taking a certain amount of sleeping pills, but you can only get such a sleeping pill so that a person cannot sit and just fall asleep while sitting, by prescription or from a grandmother’s medicine cabinet, where it fulfills its normal purpose.
• Blood pressure disorders are possible - high blood pressure is simulated by good chifir, very strong coffee, in a cup of which the ashes from one cigarette were smoked, energy cocktails in large quantities. Most likely, the called doctor will measure your blood pressure, so this is mandatory. However, you should drink coffee a maximum of an hour before the doctor arrives - otherwise the effect will subside. It is better to keep a cup ready at all times and drink quickly when the doctor rings the doorbell. It is also contraindicated for people with heart disease.
• Sometimes there is an increase in temperature - it is simulated with medication and is quite dangerous.

In general, concussion simulation is safer but less reliable.

Other consequences

In addition to those listed, other unpleasant long-term consequences of a concussion are possible, but they develop much less frequently than others. It can be:

• Psychoses, neuroses, paranoid states.
• Inadequate perception by the body of alcoholic beverages, in which poisoning, intoxication and alcoholic delirium more often occur after previously habitual doses.
• Increased production of cerebrospinal fluid, which entails an increase in the level of intracranial pressure and the occurrence of corresponding unpleasant symptoms.
• Reduced cerebrospinal fluid production - in this case, on the contrary, cerebrospinal fluid is produced in insufficient quantities, which entails the development of chronic fatigue, dizziness, apathy and headaches.

To summarize, we can conclude that concussion should not be neglected. Even a mild degree of the disease requires compliance with a special regime, since it is possible that unpleasant symptoms will develop, which are very difficult to get rid of in the future. Timely diagnosis and proper treatment will help avoid consequences and allow the patient to get back on his feet faster.

Psychological aspects

Brain tomography

• If you want to get a concussion at home without pain or almost without pain, you can use an anesthetic such as alcohol. It will also add symptoms if the doctor examines you during the day after drinking alcohol. You need to drink quite a lot - about 150 grams of alcohol practically in one gulp, otherwise there will be no analgesic effect. After this, you can get injured within 2-3 minutes.
• God forbid you call an ambulance. Emergency doctors are very serious people. They see at least one death every day, and they will not put themselves in the position of a student who takes away their precious time to extend the session.
• The best way is to call a doctor from the clinic to your home with a complaint of headaches. It is best to say that the flu is suspected, there was a temperature of 37.5 and a severe headache after a night out, where there was a fight, it is worth mentioning that a concussion may have occurred
• After diagnosing a concussion, the paramedic will write a referral to a neurologist. You need to go to him and describe all the symptoms. There is no need to indicate everything at all - you need to choose 2-3 that are visible most clearly. It is easier for a doctor to write a diagnosis of “concussion,” even if a lie is suspected, than to then answer for a person who died from a real concussion.
• A doctor from the military registration and enlistment office will never diagnose a “concussion” if in doubt. He has a good “cover” and will not be responsible for an incorrect diagnosis. A doctor from a school, university or factory health center is more likely to make such a diagnosis and send you to a neurologist.
• When examined by a doctor, it is advisable to have another adult who will describe that everything was really like this and even add details. Lying with two people is more difficult than with one. It is necessary to say everything very clearly about how exactly the concussion occurred - as a result of falling from a stool, a bucket falling on the head in the country, or an attack near the house of familiar people.
• The doctor always suspects why a police report is not filed in case of a criminal injury. Usually in this case the doctor is called by the police. Therefore, it would be better to explain everything by saying that you do not want to write a statement against a friend, colleague or acquaintance.
• You should also not contact the police - police investigators are trained to recognize lies by facial expressions or the slightest inconsistency in the words of two people. There is also liability for false testimony.
• When they demand to undergo examination by “your” doctor, you must refuse it. A certificate obtained from one doctor will be valid in any institution.
• After receiving the certificate, it is advisable to take the medical card to your home and keep it there - there are often cases when the police, in order to hush up the matter, or military registration and enlistment office workers simply took the card from the registry and said that they had not received any certificates.
• For the same reason, it is worth persuading the doctor to write two certificates - a certificate for the place of study and some place of work, even if it is fictitious.
• Some EEG data, if they come separately, should also be attempted to be stolen. Or even cut it out of the card with scissors - if anything, you can then ask the receptionist for the card and paste it in. The doctor's opinion is decisive, not the EEG results. At the same time, if the EEG does not show a concussion, this may be a reason to initiate an examination with “your” doctor, for example, at the military registration and enlistment office or at the forensic medical examination office. The EEG looks like several curves on graph paper.

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Treatment

The main task in treating a concussion, both at home and in a hospital setting, is rest and bed rest for a period of one and a half weeks to two.

Rest should be not only physical, consisting of minimal physical activity of the victim, but also psycho-emotional (exclude nervous tension, it is not recommended to watch TV, read, listen to music).

Drug treatment for concussion is based on relief of concussion symptoms and includes the following medications:

• Sedatives, the most popular of which are valerian, motherwort, and Corvalol.
• Sleeping pills: donarmil, relaxone, phenobarbital.
• Painkillers are prescribed to relieve headache attacks. For these purposes, analgin, pentalgin, dexalgin are prescribed.
• Drugs that help eliminate dizziness (Betaserc, Vestibo).
• Medicines with a general strengthening effect (complexes of vitamins and minerals, antioxidants and tonics).

How to treat a concussion

There are three degrees of severity of concussion. If it is mild, you can treat it at home, but moderate and severe means you need to stay in the hospital.

The main principle of treatment is rest. After an injury, you need to rest more and not worry. The patient should not read, watch TV, or play computer games. You can listen to music, but without headphones.

Return to work only when you have fully recovered. You will also have to wait until you are cured before you can drive a car or ride a bicycle. Contact sports - after the permission of the attending physician.

Full recovery will take from three months to six months.

Health hazard

Mechanical damage to the head leads to the fact that connections between neurons are disrupted, and nerve cells suffer from a lack of nutrients, and this negatively affects their functions. The danger of closed injuries should not be underestimated. After a severe blow or bruise, you must contact a medical facility. It is recommended to take an X-ray of the head to exclude the appearance of cracks and bruises.

In addition, you should be examined by a neurologist. It is also important to know how to recognize a concussion in order to provide first aid to the victim in a timely manner.