Medical history (history of illness) is an important component in the diagnosis of commotio cerebri (concussion). Family history Social history Current anamnesis/systemic anamnesis (somatic and psychological complaints). What symptoms have you noticed? Can you remember a triggering event (accident)? Do you suffer from headaches, dizziness and/or nausea? Were you unconscious?* If so, can anyone tell … Concussion (Commotio Cerebri): Medical History
Injuries, poisonings, and other sequelae of external causes (S00-T98). Contusio cerebri (cerebral contusion). Compressio cerebri (brain contusion)
The following are the major conditions or complications that may be contributed to by commotio cerebri (concussion): Factors affecting health status and leading to health care utilization (Z00-Z99). Suicide (suicide; threefold higher)) Circulatory system (I00-I99) Apoplexy (stroke) – two weeks after head or neck trauma in patients younger than 50 years in 0.04%; in 37% … Concussion (Commotio Cerebri): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Scale (GCS) (see below). General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? … Concussion (Commotio Cerebri): Examination
2nd-order laboratory parameters – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification in cases of unclear unconsciousness Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood). … Concussion (Commotio Cerebri): Test and Diagnosis
Therapeutic target Pain relief Therapy recommendations Analgesics/painkillers (paracetamol, metamizole). See also under “Further therapy“.
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification in cases of unclear unconsciousness Computed tomography of the skull (cranial CT, cranial CT or cCT) or magnetic resonance imaging (MRI) of the skull (cranial MRI). Abdominal sonography (ultrasound examination of the … Concussion (Commotio Cerebri): Diagnostic Tests
To prevent commotio cerebri (concussion), attention must be paid to reducing individual risk factors: Violent impact on the skull, unspecified. Prevention factors (protective factors) To prevent commotio cerebrie/head trauma (TBI), care must be taken to reduce accidents and falls. See, among other things, the respective workplace regulations. Sports at risk: ice hockey, soccer, basketball, baseball … Concussion (Commotio Cerebri): Prevention
The following symptoms and complaints may indicate a commotio cerebri (concussion): Leading symptoms Immediate loss of consciousness after trauma; maximum of 60 minutes; clouding of consciousness thereafter. Cephalgia (headache) Vertigo* (dizziness) Gastrointestinal discomfort (nausea (nausea), vomiting). Circulatory regulation disorders Amnesia, retrograde and antegrade – amnesia preceding and following the triggering event in time (memory impairment). … Concussion (Commotio Cerebri): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Commotio cerebri is a concussion of the brain. This refers to a completely reversible dysfunction of the brain that can occur in the setting of traumatic brain injury. Etiology (causes) Violent impact on the skull, unspecified.
General measures Monitoring in hospital (24-48 hours) The most important measure after a concussion is rest, which means resting for 24-48 hours in the case of mild traumatic brain injury and, when symptoms are no longer present, gradually resuming usual activities. Short-term bed rest may speed recovery. After a concussion, brain-straining activities should be avoided … Concussion (Commotio Cerebri): Therapy