Every year on March 20, World Head Injury Awareness Day is celebrated. The neurosurgeon of the neurosurgical department of the Russian Children’s Clinical Hospital of the Russian National Research Medical University named after Pirogov of the Ministry of Health of the Russian Federation Dmitry Reshchikov told Izvestia what craniocerebral injuries (TBI) are and how they occur.
First of all, according to the expert, TBI is classified according to the nature of the damage: an open wound of the head and a closed one. Separately, non-penetrating TBIs and penetrating ones are also isolated – when a traumatic agent damages the hard shell of the brain.
Reshchikov noted that the most common traumatic brain injury of mild severity, or concussion.
“The skull is a closed space, and the brain is not just inside it, but also in a limited aquatic environment. At the moment of impact, there is a concussion and a slight contusion on the walls of the skull from the inside. All this causes liquorodynamic and vascular disorders, the severity of which depends on the degree of traumatic effect, ”he said.
Among the characteristic symptoms of a concussion, the doctor called the fact of injury, short-term memory loss, headache, slight dizziness and vomiting. These symptoms usually go away after a couple of days.
“If, against the background of the start of treatment, persistent headaches, vomiting persist or increase, there is a violation of sensitivity, depression of consciousness, this is a reason for a more in-depth examination and careful monitoring of the patient,” Reshchikov specified.
He explained that TBI has a special “light period”, lasting up to 4-6 hours, during which the patient feels normal, and then experiences a sharp deterioration in the condition.
Pupil dilation is an emergency indication for surgery, the neurosurgeon added.
In the case of a more severe form of TBI – a brain contusion – the patient needs to stay in the hospital for a long time and undergo special therapy.
“With a traumatic effect, the brain swells, the amount of fluid in the intercellular space increases, and the vessels are squeezed. Due to excessive pressure, brain cells begin to die, and over time, the entire brain structure ceases to function. If an intracranial hemorrhage occurs, the body responds to this with a total spasm of cerebral vessels, there is a risk of ischemia, ”he explained.
Doctors resort to surgery if medications do not help to cope with swelling.
Reshchikov said that, as a rule, operations are aimed at removing hematomas. There are other surgeries in which surgeons make a wide window in the skull to prevent further compression of the brain.
“The neurosurgical department of the Russian Children’s Hospital has accumulated extensive experience in the treatment of patients with severe, combined craniocerebral injuries. A global multidisciplinary interaction has been developed – with resuscitators, traumatologists, rehabilitation specialists and other specialists. This allows us to provide all the necessary medical care to patients, even with the most complex pathologies,” he concluded.
Earlier, on May 20, 2022, Petr Davydov, Deputy Chief Physician for the Medical Department of the Puchkov Emergency Medical Station, warned that head injuries are the most dangerous type of injury for a person. At the same time, the doctor called the presence of bleeding from the wound the main criterion for the severity of damage. Head injuries are very dangerous and fraught with complications, so they require close attention, the specialist emphasized.
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