Synonyms
Commotio cerebri, skull-brain dream (SHT)
Definition
The term “concussion” refers to a slight craniocerebral trauma caused by external force applied to the head. In most cases, the concussion does not cause permanent damage to the brain and is considered to be completely reversible.
Introduction
Concussion (technical term: concussion cerebri) is one of the most common injuries in the area of the head. In most cases a concussion occurs in connection with an accident. In most of the affected patients a concussion manifests itself by a temporary loss of consciousness and memory (amnesia).
In addition, a concussion can lead to severe headaches, dizziness, nausea and vomiting. Although the concussion is a serious disease, the typical symptoms usually subside without complications within a few days. The cause of the craniocerebral trauma is usually a force impacting the head from outside.
The concussion can be caused, for example, by a jerky movement (e.g. in a fall). The actual trauma in the area of the brain is caused by the fact that the brain floating in the cerebrospinal fluid (liquor) is pressed violently against the skull bone. If a patient is suspected of having a concussion, a doctor should be consulted immediately.
In such cases, serious injuries to the bony skull and brain substance must be ruled out. However, a simple concussion without further injuries does not cause permanent damage in most cases. Affected patients should take it easy within the first few days and avoid any excessive physical activity.
Symptoms
In most of the affected patients, the presence of a concussion is indicated by typical symptoms. The classic signs of a concussion include a brief loss of consciousness following the trauma. In most cases, this unconsciousness lasts only a few seconds.
However, in some of those affected, the unconsciousness persists for several minutes. Immediately after the causal trauma, the concussion sufferer is often unable to remember the exact course of the accident. These memory gaps (amnesia) can cover both a period before (retrograde amnesia) and a period after the accident (anterograde amnesia).
In addition, some of the people who suffer from a concussion appear dazed and absent immediately after the causal event. The occurrence of impaired balance and associated dizziness is also one of the typical symptoms of a concussion. In addition, a slowing of the pulse (bradycardia) and lowered blood pressure can be observed in the affected patients.
Severe headaches with nausea and vomiting are also typical symptoms of a concussion. Symptoms at a glance: Headaches Unconsciousness Nausea Vomiting Fatigue/exhaustion Bradycardia Hypotension Equilibrium disturbances/dizziness Memory gaps (amnesia) The symptoms of concussion need not occur immediately after the accident. In many cases, the symptoms only set in with a delay.
Depending on the severity of the concussion, the classic symptoms can only appear up to twelve hours after the accident.
- Headaches
- Unconsciousness
- Nausea
- Vomiting
- Tiredness/fatigue
- Bradycardia
- Hypotension
- Balance disturbances/ vertigo
- Gaps in memory (amnesia)
As a rule, memory disorders occur in the course of a concussion. These are called amnesia.
The affected person cannot remember the moment of the head trauma and a certain time afterwards. This is referred to as anterograde or post-traumatic amnesia. Often the injured person cannot remember events shortly before the accident either.
This is described in technical jargon as retrograde amnesia. The temporal extent of this memory disorder does not correlate with the severity of the concussion and the duration of the loss of consciousness. Usually, the events prior to the accident are not completely erased.
But often they are no longer retrievable. This recall disorder can also persist permanently. Nausea often occurs because the concussion releases various messenger substances.The nausea can occur immediately after the head trauma or 6-12 hours after the event.
If the nausea is severe, medication against the nausea, so-called antiemetics, can be taken temporarily for relief. For example, Domperidone drops or Dimenhydriant can have a soothing effect. In the context of a concussion, the vestibular organ can become overexcitable.
The excitability of the vestibular system can activate the vomiting center. This leads via various mechanisms to vomiting. In addition, vegetative complaints such as sweating, increased salivation, vasoconstriction and tachycardia can occur.
Drug treatment is usually the same as for the symptom of nausea. Vomiting can also be triggered directly after the head trauma or many hours later. If the pupils are dilated to different degrees, this may be a sign that the brain is damaged.
If the carotid artery has been damaged, the so-called Horner syndrome can occur. Here one pupil is constricted. A diagnosis can be made by measuring the pupil width, the cocaine test and the pholedrin test.
The symptoms in the toddler and child with a concussion can manifest themselves differently. Short-term unconsciousness, drowsiness, severe headaches, dizziness, neck pain, nausea and vomiting are often clear signs. The nausea and vomiting can also occur with a time delay of many hours after the event.
Usually there are slight memory gaps shortly after the head trauma. In the case of a concussion, unconsciousness can last from a few minutes to an hour. If the child is not yet able to speak, he or she may increasingly touch the head or repel any contact with it.
Small children can also express neck pain through altered or apparently painful head movements. Furthermore, light sensitivity can occur, which small children sometimes clearly demonstrate by pinching or holding their eyes. In addition, restlessness, aggressiveness, irritability and tearfulness can be expressions of pain in small children.
If a change in the child’s nature occurs and a concussion is suspected, this should definitely be clarified by a doctor. In addition, pupils of different sizes can be a sign of brain damage. Only a doctor can assess the severity of the condition.
If a child or toddler has fallen on his or her head or has injured his or her head, a medical examination will be carried out. or vomiting in the case of an infantIf a child or toddler falls or injures his or her head, a fracture of the base of the skull may occur. It is important to differentiate the basal skull fracture from a concussion.
A basal skull fracture can manifest itself by blood running from the nose or ear without directly damaging these parts of the body. Also, the bump on the head is usually soft and can be an indication of a basal skull fracture. In addition, bruises around the eyes can be an indication of a basal skull fracture. A medical examination and treatment are urgently required.
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