Signs of concussion for 8 years. Concussion in a child: severity, symptoms, diagnosis and treatment

Concussion in children requires careful monitoring of the condition and behavior of the baby. In the chest period, the signs of a concussion resemble the symptoms of acute respiratory infections, intestinal colic, teething, that is, general manifestations of malaise. A child 2 - 4 years old is not able to accurately formulate his feelings and complaints. Therefore, it is quite difficult to diagnose this injury at an early age. But the remote consequences of concussion in the form of neurological disorders and developmental delays can be very serious. Therefore, only the attentiveness of the parents can help to diagnose in time and save the child from unnecessary risks.

What is a concussion in a child

The phenomenon is the least severe type of closed traumatic brain injury with a mild degree of brain damage at the cellular level, without significant disruption of the integrity of soft tissues, destruction of the cranial bones.

At the same time, pronounced organic disorders in tissues, changes in the medulla are not detected, and disorders of the nervous system are reversible.

Medical statistics and underlying causes of cerebral concussions in childhood

Among the children's population of Russia, concussion is diagnosed every year in almost 120 thousand young patients of different age groups. Among them: newborns about 2%, infants 24 - 25%, babies under 4 years old - up to 8%, children from 4 to 7 years old - 20 - 22%, adolescents from 8 years old - over 45%.

Concussion in infants is caused by falls from sofas, changing tables, intense motion sickness with strong shaking, in children who have started to walk - with active development of space, moving through rooms, stairs. In older babies, falls from wheelchairs, from swings, ice slides, ropes and rope ladders lead to injury. The risk of concussion is increased in schoolchildren when climbing in sports areas, falling from bicycles, playing football and hockey.

Early childhood specificity

Pediatric anatomy and physiology differ significantly from adult anatomy. In proportion, the head (and brain) of a child occupies a much larger portion of the entire torso than that of an adult. Even by the silhouette, you can always distinguish a teenager by a disproportionately large head, especially a toddler under 5 years old or a baby. Therefore, the younger the child, the sooner it will hit the head during the fall. Most often in babies, the crown, forehead and back of the head are injured.

The manifestations of cerebral concussion in early childhood differ in many respects from the signs characteristic of children over 10 years old, which is explained by the characteristics of the body of a young child. These include:

• incompleteness of ossification, plasticity, flexibility of the bones of the skull, loose, and in newborns even mobile - the joint;
• immaturity of brain tissue and its saturation with fluid, incomplete differentiation of nerve structures and arterial-venous circulation.

Because of these features, the brain tissue in babies is protected to a certain extent by the shock-absorbing (softening) properties of the soft bones of the skull and fluid.

However, the underdevelopment of the brain structures also causes their easier disruption during trauma, leading in the future to a much greater probability than in adults, the likelihood of a delay in the mental and intellectual development of the baby, and emotional disorders.

Despite the high plasticity of the skull bones and the shock-absorbing properties of the brain substance in a child, in 30% of cases of concussions that have not been treated, post-concussion syndrome develops, expressed in constant dizziness, neuroses, intense headaches, insomnia, irritability, increased fatigue and anxiety, inability concentrate.

Doctor Komarovsky about a concussion. If the child fell

Symptoms and early signs

Signs by which one can suspect that after a stroke, a bruise, a concussion has occurred in a child, differ in children of different ages and also depend on the degree of damage in the event of a brain injury.

Given the severity of the manifestations, three types of concussion are classified:

• I degree (mild manifestations). The victim does not lose consciousness even for a few seconds, and the pathological symptoms persist for no longer than 15 minutes and disappear without treatment. But it is imperative to show the baby or adolescent to the doctor in order to absolutely exclude possible serious injuries or another type of traumatic brain injury.
• II degree (moderate). The child is conscious, but signs of brain damage and disorientation in time and space appear for more than 15 minutes.
• III degree (severe injuries) - the victim has a short (up to several seconds) or prolonged loss of consciousness. Symptoms can last for up to several days.

It should be borne in mind that babies under one and a half, sometimes up to two years old, with a concussion, rarely lose consciousness. Therefore, the basic criteria for determining the severity of injuries refer to older children.

The main indicators by which the severity of the condition of children over 3 years old after receiving a concussion is determined:

1. Time of loss of consciousness - the longer the child is unconscious, the more severe the damage.
2. Desire for vomiting, nausea - the more pronounced and longer they persist, the deeper the injury.
3. Identification of the so-called retrograde amnesia, in which the adolescent is unable to remember the events that took place before the injury. The longer the "forgotten" period of time, the more the child suffered.

Symptoms of concussion in children of different ages by severity Table 1

Severity	Babies, children under 1.5 years old	Children from 1.5 - 2 to 6 years old	Pupils
I	In children under one year old, symptoms are usually mild. Observe: pallor; increased regurgitation; sleep disturbance, difficulty falling asleep, frequent awakenings, not typical for a baby earlier; or vice versa - increased sleepiness during normal periods of wakefulness with long sleep at night; strong excitability or lethargy unusual for a baby; crying for no reason; strange crying - monotonous or uncharacteristic for a baby; refusal to breast or bottle; sweating	pallor; perspiration; nausea; weakness; moodiness when eating, during games.	lethargy; loss of appetite; headache; irritability; sudden flushes of blood to the face and redness, which is replaced by a sharp pallor.
II	frequent loose stools; temperature increase; twitching of handles, legs; trembling fingers, chin; bulging fontanelle in an infant sometimes - vomiting, more often single; belated crying after an interval of absence of screaming and crying (most often this is a sign of a short-term "shutdown" of consciousness).	bouts of vomiting; cold sweat; temperature; Strong headache; brief clouding of consciousness; Difficulty focusing your gaze dizziness when trying to move; darkening in the eyes; acceleration or vice versa - slowing down of the heart rate; drop or increase in blood pressure; disorientation in time and space; stunning, short-term hearing loss, hissing and ringing in the ears; immunity to harsh sounds and light.
III	The symptoms of the first degree of severity are joined by: repeated vomiting, which is easily confused with profuse regurgitation; headache, which in infants can be expressed in restless movement of the head against the pillow, rubbing with the fists of the ears, as in otitis media; impairment of consciousness: episodes of loss of consciousness after a concussion are extremely rare in infants, and such a symptom means serious damage and the likelihood of a brain injury.	short memory loss of events preceding the trauma (in children after 5 years); dizziness even when lying down; post-traumatic blindness that occurs immediately after a blow to the head or after a while and lasts from 5 to 20 minutes to 3 to 10 hours. Disappears on its own. The reason is not clear. divergence of the eyeballs (squint); gaze paresis (scattered eye movements, more often vertical); pain when moving the eyeballs; unnatural twitching of the arms and legs, similar to convulsions; speech disorder, inability to clearly express thoughts; impaired coordination of movements.
	The expansion and contraction of the pupils on the left and on the right is uneven (different diameters)
	Repeated vomiting, excruciating nausea, severe dizziness

After a child falls, bruises, or blows to the head, an ambulance should be called immediately if:

1. An infant, child, teenager fell asleep for a long time after hitting his head.
2. A toddler or teenager is severely nauseous with bouts of repeated vomiting.
3. The child complains of severe headache, double vision.
4. He breathes frequently and heavily against a background of severe pallor and perspiration.
5. He cannot pronounce words clearly, he gets confused in speech.
6. His movements changed, becoming uncoordinated or convulsive.
7. In the baby, the fontanelle protrudes strongly.
8. There is a different size of pupils, strabismus, eye trembling.
9. A watery or mucous fluid, blood appears from the nose or ears.
10. The kid loses consciousness, and after the injury does not remember what happened.

The specificity of concussion in children is expressed in the fact that a generally satisfactory condition in 10 - 48 hours suddenly deteriorates.

Time-out symptoms

These signs often accompany the state of head trauma in a child, manifesting immediately after a concussion or after 2 to 5 days.

• headaches and slight nausea;
• irritation to light and sounds of normal intensity;
• unreasonable tearfulness;
• overexcitement or lethargy;
• increased irritability;
• quick mood swings;
• restless night sleep with prolonged falling asleep, sudden awakenings;
• the inability to concentrate on a conversation, a game, a specific occupation.

Diagnosis of concussion in children, including newborns and infants

To confirm or deny the diagnosis of a concussion, the injured child should be examined by a traumatologist, pediatric neurologist, possibly a neurosurgeon. It is obligatory to measure intracranial pressure with an ophthalmoscope for a small patient.

The main instrumental methods for confirming or excluding the diagnosis

X-ray

This diagnostic method is common for concussion and is performed in most cases and allows the specialist to see possible fractures of the cranial bones. The detection of any type of bone injury means that the injury is classified as moderate or severe, given the patient's condition. In young children with quite satisfactory symptoms, fractures of the cranial bones are often found on the roentgenogram. However, the possibilities of radiography do not allow assessing the state of the medulla.

Neurosonography NSG or ultrasound examination of the brain structure

The optimal and safe way of multiple examinations for babies whose fontanel has not yet closed, and children under 2 years old. The bones of the skull at this age are thin, and the quality of neurosonograms easily makes it possible to identify foci of inflammation in case of injury, signs of edema. The medulla, the ventricular system, hematomas and hemorrhages (life-threatening) are clearly visible. Many children's hospitals are equipped with the equipment for carrying out NSG, but it is not always possible to carry out an emergency examination at night.

Echoencephalography or Echo-EG

An examination method using ultrasound, which allows one to suspect hematomas, edema and neoplasms, to give an idea of ​​the state of the brain tissue and the ventricular system. Echo-EG is assessed as a quick, simple, but not very accurate method.

Computed tomography (CT)

An ideal and high-precision method with the ability to diagnose various injuries to the bones of the skull, vascular pathologies, foci of inflammation and hemorrhage, edema, hematomas, and obtain high-definition X-rays.

Magnetic resonance imaging (MRI)

It is rarely used in the diagnosis of concussions and possible complications due to the impossibility of examining the bones of the skull and insufficient accuracy in detecting hemorrhages.

The widespread use of both types of tomography in infants and children under 3 years of age is difficult, since both methods require anesthesia for complete immobility of the baby with a sufficiently long examination (10 - 20 minutes).

Electroencephalography (EEG)

Provides opportunities for the study of brain activity in the bioelectric plane. It is used, as a rule, to determine the severity of a concussion, to detect foci of epileptic activity (areas of the cerebral cortex with pathological changes in neuronal activity that can lead to epileptic seizures).

Lumbar puncture

It is performed if there is a suspicion of cerebral hemorrhage and the impossibility of performing neurosonography. Diagnostic manipulation is the intake of fluid that envelops the brain and spinal cord (CSF) from the spinal cord canal at the lumbar level for examination. Changes identified in the substance of the cerebrospinal fluid (blood cells, leukocytes) indicate probable injuries, hemorrhages, inflammation.

With an attentive attitude to any strange symptoms after the child has hit his head or underwent intense shaking, as well as with early diagnosis of a concussion and following the recommendations of a neurologist, serious pathological changes in the substance of the brain and nervous activity are not expected. Since gross changes in the brain structures do not occur, such a brain injury, being the most frequent in childhood, rarely leads to complications and, as a rule, has a favorable outcome.

Concussion occurs in 90% of all head injuries in children. This is the most harmless damage possible, but this does not mean that you do not need to pay special attention to it. It is important to take timely measures to prevent serious consequences for the child.

What is the danger of a concussion for a child

A concussion is a mild degree of brain damage that is not accompanied by fractures of the skull bones. In children, these injuries are very common, and with the right approach, complications are rare. A distinctive feature is a short loss of consciousness after a blow. Changes in the brain occur at the cellular level and are not detected during research.

Concussion is common among children and can be serious

This condition is especially dangerous for newborns and babies of the first year of life, since at this age the symptoms may not be noticed, and the body is not yet ready for such loads. Older children can report how they are feeling, and their signs of a concussion are more obvious.

When symptoms appear, it is important to take immediate action and call an ambulance to rule out more serious head injuries. The specialist prescribes diagnostic measures, and if there are indications, he can recommend hospital treatment.

Classification

Traumatic brain injuries are open and closed (depending on the presence and degree of damage to the bones of the skull). And the nature of the damage is also taken into account:

1. Brain contusion is a dangerous condition that causes brain edema. It can occur with both open and closed trauma. Provokes an increase in intracranial pressure, requires immediate medical attention.
2. A fracture of the skull bones is an equally serious injury that can result in mechanical injury to the soft tissues of the brain.
3. Concussion - in most cases it does not pose a serious danger, the symptoms disappear within a few days.

Concussion severity is classified into three degrees of severity:

1. Easy - consciousness is absent for no more than 5 minutes;
2. Medium - loss of consciousness from 5 to 15 minutes;
3. Severe - prolonged absence of consciousness, can go into a coma.

The latter condition is the most dangerous, as it can cause irreversible changes in the brain.

Causes and factors of development

Concussion in children is common. May occur after a blow to the head or to the head. And also sometimes there is a "shaken child syndrome", when injury occurs without the impact. This can happen with excessive shaking of a baby in a stroller or other rough treatment of a baby.

Infants who have not yet walked often suffer from parental carelessness. The fourth - fifth month is especially dangerous, when the child is just beginning to roll over on his stomach. Adults may simply not expect this from a toddler, and leave him unattended on a sofa, changing table, or other raised platform.

Parents of babies who have just learned to roll over should be especially careful

Older children, starting to walk, try to climb higher and higher, but the vestibular apparatus is not yet fully formed. Therefore, falls and, as a result, head bumps occur.

Children are more prone to head injuries as they are proportionally larger and heavier than adults. Among other things, the child's fear of falling or damaging something is often not fully realized, which contributes to the search for new heights. At a young age, the baby still cannot put his hands up in time during a fall from a height, which also favors "landing" on his head.

Symptoms

Small children very often fall and bang their heads. It is important to remain calm at such moments and objectively assess the situation. Knowing the symptoms makes it easy to identify a head injury. In other cases, you do not need to panic, but carefully monitor the child for the next day.

The first and fundamental sign of a concussion is considered to be loss of consciousness after a stroke. When the child has come to his senses, he may not remember for several minutes before falling. Other major symptoms of brain injury are:

• vomiting, most often repeated (if the child vomited only once, this may be the body's reaction to stress);
• confusion (inadequate answers to simple questions, not understanding what is happening);
• post-traumatic blindness (rare, occurs only in children, disappears after a few minutes or hours);
• headache;
• dizziness;
• drowsiness;
• apathy or excessive agitation;
• capriciousness.

If the loss of consciousness has not occurred, this does not always mean that there is no cause for concern. It may be another traumatic brain injury, the symptoms of which appear with some delay.

With a concussion, all symptoms disappear on their own after a few days, if you follow the recommendations of doctors and take the necessary measures in time.

Diagnostics and differential diagnostics

It is impossible to diagnose a concussion with the help of any research, therefore the diagnosis is made on the basis of the general clinical picture and symptoms. The sequence is always this: the child bumped, lost consciousness, symptoms appeared.

You need to react to the symptoms of a concussion in a child with lightning speed.

Diagnostic measures in a hospital environment are carried out in order not to miss more serious injuries. The following studies can be prescribed:

1. X-ray of the head. It is carried out to assess the condition of the bones of the skull; this is the simplest and most obligatory procedure.
2. Neurosonography. This is an ultrasound of the brain. The procedure is indicative for children under two years old, when the bones of the skull are still thin. With its help, you can detect a brain injury, if any.
3. Computed tomography (CT). Allows you to clearly see all the damage, assess the state of the cranium and medulla. However, this method is not always used due to the lack of equipment in the hospital.
4. Magnetic resonance imaging (MRI). This test is rarely done in head injuries because it is very expensive. The method is accurate, it helps to detect any, even the smallest damage. An MRI scan can be prescribed if the symptoms of concussion persist for a long time, despite treatment and adherence to all the doctor's recommendations.

Other examinations may be prescribed for special indications and are rarely performed in children.

Treatment

A concussion requires an immediate ambulance call. Upon arrival, the doctor will without fail take the child to the hospital for examination and consultation with a neurologist or neurosurgeon.

Inpatient treatment is strongly recommended when diagnosing concussion in children. First of all, this allows medical supervision during the first days after the injury. It also promotes the child's stay in a calm environment with an established routine. Parents can refuse to leave the baby in the hospital if they are absolutely sure that they can create the necessary conditions for him at home.

First aid

If, after hitting the head, loss of consciousness occurs, it is necessary to lay the child on one side. If there is bleeding, it is stopped with an ice pack. Something cold is also applied to the impact site.

If, after hitting the head, the child has lost consciousness, it is necessary to lay him on one side.

When the baby has come to his senses, it is necessary to calm him down and not allow physical activity. It is important not to let him fall asleep for at least an hour immediately after the injury. In this way, possible violations can be detected.

Even if no concussion symptoms are found in the first hours, it is necessary to carefully monitor the child's behavior. On the first night after the incident, you need to wake up the baby several times to assess his condition.

For any suspicion of a concussion, be sure to call an ambulance. Even if it is a "false alarm", it is better to play it safe.

Drug treatment

Inpatient and home therapy is aimed at preventing possible complications. The following groups of medicines are usually used:

Related measures

The main condition for a quick recovery is rest, preferably bed rest.... It is not always possible for young children to comply with this requirement. It is necessary to reduce the activity as much as possible - to captivate the child with a calm game, read books to him.

Watching TV, sitting at the computer, using any other gadgets is completely excluded. The eyes should not be straining to allow the brain to rest as much as possible from the shock.

After an injury, watching TV is completely excluded

As for nutrition, it is better to exclude heavy foods during treatment. It is not recommended to use:

• strong tea;
• coffee;
• chocolate;
• fatty;
• roast;
• spices;
• salty.

These foods increase intracranial pressure and promote fluid buildup, which can lead to cerebral edema. The influence of food is not too great, but sticking to such a diet for a few days does not hurt.

Consequences of a concussion in children

In most cases, this injury does not cause serious complications. If you follow the regimen and the doctor's recommendations, all symptoms disappear within 1-2 weeks. However, with incorrect or untimely treatment (and sometimes regardless of this factor), the following consequences may occur:

• the impact of weather changes on overall well-being;
• irritability, moodiness;
• lethargy;
• frequent headaches;
• insomnia and other sleep disorders;
• periodic unreasonable bouts of vomiting;
• epileptic seizures are very rare.

In rare cases, such complications can bother the child for another 1–2 months after the concussion, and sometimes longer. If such residual effects are found, it is necessary to consult a doctor for consultation and development of tactics for further treatment.

Prophylaxis

It is difficult for children to take adequate measures to prevent falls. But you can do the best you can:

• do not leave babies unattended on a hill;
• use a helmet when cycling and other active sports;
• isolate sharp corners in a house where there is a child under three years old. And also restrict access to any elevations - window sills, tables, cabinets, etc.;
• talk to older children, explain the danger of injury;
• try not to allow a large number of objects in the house that you can trip over;
• use non-slip shoes or socks for the child if the floor in the apartment is slippery - linoleum, tiles, etc.

Video: Dr. Komarovsky on concussion in children

All children, from the first steps, fall and hit their head. You don't have to run to the hospital or call a doctor every time. The main thing is to observe the behavior of the child, not to panic. The kid, seeing the excessive concern of the parents, may be frightened himself. Any sign or even suspicion of a concussion or other traumatic brain injury requires medical attention. With timely admission to the hospital, there is practically no risk of complications.

Is it possible to find in this world a creature more curious and fearless than a child? The thirst for knowledge and the lack of a sense of self-preservation, which is natural for an adult, pushes him on exploratory adventures, which often end in injuries.

Concussion is one of the most common and at the same time dangerous consequences of falls, bumps, sports injuries and other emergencies that occur almost daily to children of all ages. You will learn how to recognize a concussion, effectively provide first aid, and how it threatens if left untreated, you will learn from our article.

General information

Everything is provided by nature so that the brain of a person, and especially a child, is reliably protected from damage. The bones of the skull prevent the severe consequences of blows: they are not only very strong, but also mobile, therefore they have the ability to shock absorb when in contact with a hard surface. An additional shock-absorbing role is played by the cerebrospinal fluid - the fluid that is located between the brain and the bones of the skull and during the impact prevents them from colliding.

Brain protection for newborns is additionally provided by the fontanelle (a physiological opening in the parietal part of the skull) and the softness of the bones.

Thanks to these factors, most blows to both the head and the head end well, especially in cases with young children, whose weight is not yet sufficient to create strong inertia and a powerful push.

To get a concussion, it is not enough just to knock - the shock should not be so strong as in amplitude, that is, it should occur in a big way (it often happens in car accidents, sports competitions). In this case, the cerebrospinal fluid does not cope with the role of a shock absorber and the brain hits the skull bone, resulting in a temporary violation of its functionality of varying severity.

Symptoms and Signs

Symptoms of a concussion in children depend on factors such as the severity of the injury, the age of the victim, and the presence or absence of the integrity of the cranial bones.

The most characteristic instant signs by which you can quickly identify the disease include:

• pallor of the skin, which can be replaced by a sharp erythema (redness of the face);
• temporary astigmatism (desynchronization of pupil movements);
• single or repeated vomiting;
• children 2-3 years old and older may complain of a sharp headache;
• loss of consciousness of varying duration;
• change in heart rate (increased heart rate, slowing heart rate);
• shortness of breath;
• bleeding from the nose;
• an increase or decrease in the size of the pupils, the lack of their response to stimuli.

In the absence of timely diagnosis and adequate medical care, signs of a concussion in a child become less pronounced, but at the same time protracted:

• general lethargy (decreased activity, lack of interest even in favorite activities;
• frequent aching pain in the head;
• noise in ears;
• dizziness and other disorders of the vestibular apparatus;
• excessive sleepiness, or, conversely, difficulty falling asleep.

In a nursing infant, a concussion is rare and may present with minor symptoms such as profuse regurgitation, increased anxiety, and sleep disturbances, which the parents mistake for indigestion. If the blow was light, then symptoms usually do not last longer than 1-3 days.

Regardless of age, the temperature does not change during a concussion, and if there is an increase, then this indicates an independently occurring viral infection.

From one blow (bruise), the brain can receive two injuries due to the so-called counter-impact

A symptom such as a violation of the integrity of the bones of the skull requires separate mention. If, after a blow, their fracture is noted, then this is an indication for the diagnosis of "head injury". Such a diagnosis may be accompanied by the same symptoms as with a concussion.

It is impossible to differentiate these conditions on your own at home - this requires special medical equipment. The first and foremost task of parents is to transport the child to the emergency room as soon as possible.

Severity

With close observation, you can determine not only the fact of the concussion, but also the severity of its course. According to the generally accepted medical classification, there are three degrees of the disease.

Knowledge of their distinctive characteristics will tell parents how to identify a concussion in a child at home, help them better navigate the situation and respond correctly.

• First degree

It is characterized by minor physiological disorders such as headache, dizziness, and short-term weakness. Additional symptoms of mild concussion: nausea, single vomiting, in a child under one year old - regurgitation.

The main difference between the first degree of the disease and more severe is the time during which the symptoms appear. If the patient's condition improves within 30-60 minutes, he seeks to return to his usual activities, his complexion improves, this indicates that the most dangerous period is over.

However, this does not mean that a mild concussion does not require hospital diagnosis and treatment - in any case, the child should be taken to the hospital, where he will have an X-ray of his skull, and make sure that there are no microcracks and internal hematomas. This measure will allow avoiding possible negative consequences of trauma, such as headache of unknown etiology, etc.

• Second degree

The first signs of a second-degree concussion appear in the same way, but are observed over a longer period of time. The disease can be complicated by short-term loss of consciousness (1-2 minutes), lack of ability to concentrate gaze, mental clouding.

Older children (10-12 years old) complain of a feeling of fog in the head, extraneous noises, inability to maintain balance. The condition is often accompanied by profuse repeated vomiting. Pupils respond to light more slowly than they normally would.

You can understand that a child has a second-degree concussion if you ask him the simplest age-appropriate questions. Children under 1 year of age and a little older, who still speak poorly, can only be diagnosed with a differential diagnosis by a doctor.

• Third degree

In the third degree, the patient may lose consciousness for a period of up to 5 minutes. He is very pale, lethargic, unable to change his body position on his own. Sometimes short-term amnesia is noted - the child is not able to remember his name, does not recognize those around him, he has no orientation in time.

Pupils with a third-degree concussion do not respond to light, there is a difference in their size. This indicates severe damage to one or both hemispheres of the brain. The child's pulse is uneven - it sometimes quickens, then becomes slow, depending on this, the intensity of inhalation and exhalation changes. The condition is accompanied by increased sweating, perspiration appears on the forehead.

If the loss of consciousness lasts longer than 5 minutes, it leads to irreversible consequences and requires urgent medical resuscitation measures.

When do the first symptoms appear?

Parents often find it difficult to diagnose a concussion in a child for two reasons:

1. Lack of information about the injury.
2. Long time interval between injury and symptom onset.

Fearing parental anger, children often hide from them the fact that they fell or hit during a walk, school recess, a fight, or training. A situation in which brain damage begins to manifest itself several hours later also disrupts the visible connection between the cause of the disease and its consequences, making diagnosis and treatment difficult.

Therefore, it is important to remember that severe degrees of the disease make themselves felt immediately after injury, but the lungs are more insidious and can make themselves felt after 2-3 hours. Pay attention to the combination of symptoms. If it is vomiting, accompanied by dizziness and / or headache, be sure to ask your son or daughter about possible bumps, falls, collisions and other troubles that may have occurred.

Regardless of how long a child's concussion occurs, it must be shown to a doctor to clarify the diagnosis.

First aid

First aid depends on how a child's concussion manifests itself, but the very first action of an adult is to call an ambulance. After that, it is necessary to examine the head and, if there is damage to the skin, treat the wound with a non-alcoholic antiseptic (chlorhexidine, hydrogen peroxide), stop bleeding with a cotton-gauze swab, apply a bandage. The use of an alcohol antiseptic can cause painful shock in a child.

If the soft tissues of the head are damaged, but there are no signs of a concussion, be sure to call an ambulance too - the symptoms may reveal themselves later.

At the first degree

If the victim is conscious, and his condition does not cause concern (vomiting with a first-degree concussion may be absent, there are complaints of mild headache, slight dizziness), you can take him to the hospital yourself, but in no case on public transport ... However, this is an extreme, undesirable measure, since in the car it is impossible to fix the patient well in case of shaking and to provide him with a horizontal position in compliance with safety precautions.

Surgeons, neurosurgeons and neuropathologists are involved in diagnostics and treatment, but if you do not know exactly who to take your child to in case of a concussion in your area, go to the nearest traumatology department - there he will be provided with medical assistance and, if necessary, transported to the destination.

In the second degree

With a second-degree concussion, that is, when vomiting, nausea, headache are present, but there is no prolonged fainting, the child must be provided with a horizontal position. Do not let him fall asleep before the doctors arrive - after sleep, against the background of a traumatic brain injury, the symptoms may appear more pronounced, the patient will become more lethargic, the consciousness - impaired.

In the third degree

In the event of a serious injury accompanied by loss of consciousness, the patient should be placed on a horizontal flat surface on his right side, put his right hand under his head, and bend his legs slightly at the knees. Bend your left arm at the elbow and lay it loosely along the body. This will help to give the victim an optimal physiological position, temporarily fix it in case of sharp convulsive movements, and also protect him from choking with sudden onset of vomiting.

What to do is unacceptable:

• leave the patient unattended, regardless of the severity of the symptoms;
• when unconscious, shake him, trying to bring him to his senses;
• put on your back;
• put in a position in which the head is located below the body;
• ignore symptoms, self-medicate.

Also, you can not arrange a fuss near the victim, scare him, upset, make noise - all of the above will only aggravate the condition.

Hardware diagnostics

In addition to the doctor's collection of anamnesis, clarification of the circumstances of the injury and an objective assessment of the external manifestations of the disease, diagnostics necessarily include hardware techniques, the choice of which depends on the severity of the symptoms.

Their arsenal includes:

1. X-ray - helps to identify a fracture of the bones of the skull.
2. Neurosonography is an ultrasound examination that shows the state of the cranium and brain in children from birth to 2-3 years old.
3. Magnetic resonance imaging (MRI) - shows the state of the brain, the presence of neoplasms and hemorrhages in it.
4. Computed tomography (CT) - allows you to see all the same nuances as MRI, but takes less time, so it is more often used with young children.
5. Electroencephalographic examination (EEG) - is used after treatment if the injury was severe. With the help of this examination, you can see which parts of the brain show pathological activity, and adjust the treatment of the consequences.

Some types of examinations (MRI, CT) require prolonged immobilization, therefore they are difficult to use with small, restless, and also hyperactive children. Therefore, they are prescribed only in cases of extreme necessity and are carried out under general anesthesia.

Treatment

Therapy of the second and third degrees of concussion is carried out in a hospital setting. This allows you to quickly remove the patient from a serious condition and minimizes the negative consequences of the disease. The child is provided with rest and bed rest, the optimal way of administering medications is oral or intravenous (through a dropper).

Treatment of concussion in children necessarily includes diuretic drugs that prevent the occurrence of puffiness, nootropics that accelerate the process of restoring brain functionality, as well as anticonvulsants and drugs that normalize intracranial pressure. Symptomatic treatment consists of taking pain relievers and sedatives, sometimes antihistamines may be needed.

For the first degree of concussion, outpatient treatment is allowed. Home care means providing peace of mind, protecting the child from sudden movements and negative emotions. Of great importance in the treatment of the disease and its consequences in a school-age child is a strict restriction on watching TV and playing computer games - such entertainment has an exciting effect on the nervous system and slows down the recovery process.

A patient who is on outpatient treatment must be provided with timely intake of all medications prescribed by a doctor. Despite the absence of severe symptoms, he is also prescribed light nootropics, the use of which improves cerebral circulation, improves memory and alertness, and also prevents the development of complications.

During the recovery period, the child should be limited in physical activity, exempt from physical education lessons at school, and take a break from sports activities. While walking with friends, children are very active, so this pastime is also temporarily prohibited. Returning to a full life is possible after the diagnosis is removed and the doctor's permission is given.

Complications

Timely diagnosis and treatment are two components of a complete recovery from the consequences of trauma. In their absence, even a slight concussion of the brain is dangerous with various consequences, many of which can darken the rest of your life.

Among them:

• poor memory;
• decreased concentration of attention;
• weather dependence;
• migraine;
• dizziness;
• fear of heights and other phobias;
• pressure surges;
• anxiety;
• neuroses (obsessive movements, nervous tics);
• tendency to seizures;
• epilepsy.

A moderate and severe concussion at any age also increases the likelihood of senile dementia, accelerates its onset, aggravates the course. In girls, trauma can negatively affect subsequent pregnancies, which are often complicated by the threat of termination due to hypertensive crises.

Can you prevent it?

"If I had known where you were falling, I would have spread the straws." This proverb fully reflects the degree of unpredictability of any injury. However, it is possible to reduce the risks if you follow basic safety precautions.

With infants, it consists in not leaving them unattended on changing tables, sofas and any other elevations under any circumstances. This rule is immutable even in the case of newborns who do not yet know how to turn on their own.

Lower the bottom of the crib and / or playpen in advance, without waiting for the child to learn to sit down or get up. This should be done in advance, at the first attempts of the baby to move to the next level of physical development. If there are stairs in a private house, install special fences.

When the baby learns to crawl and walk, supervision should become even more careful, because the likelihood of injury increases many times over. Observe safety measures in the playground and gradually teach your child to do this. As you grow up, explain to him the rules of behavior in public places - kindergarten, school, instill prudence, caution and a tendency to self-preservation.

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Of all childhood injuries, the most common is concussion in a child. In a mild form, subject to rest and the doctor's recommendations, it does not pose a danger to the baby's health. In case of severe trauma, leading to serious disorders in the structures of the brain and skull bones, the timely provision of care and delivery of the child to the hospital increases the likelihood of a speedy recovery and minimizes the risk of complications in adulthood.

How concussions occur, the main causes

A concussion in a child involves the displacement of the brain structures to the side, their impact on the bones of the skull and return to their place. The reason for the displacement of the brain can be a blow to the head, unsuccessful jumps with a landing on the heels or buttocks, sudden braking, leading to a jerk with the head forward. In infants, a slight concussion can even cause severe motion sickness.

The causes of childhood injuries and the resulting concussion can be divided according to the following age groups:

1. Newborns and children under 2 years of age. The cause of injuries at this age is the negligence of the parents in relation to their child. Concussion in infants is often the result of falling from a cot, stroller, changing table, or the arms of an adult. Up to a year, the baby's head outweighs the weight of the whole body, so when falling, it turns over, and the blow falls on the fragile bones of the skull.
2. Children aged 2-6 years. Increased activity of the child, imperfect motor skills and motor coordination, combined with the lack of fear of danger and curiosity characteristic of this age, lead to frequent falls on a hard surface (including the buttocks), bumps against the wall or sharp corners of furniture.
3. Children from 7 years old. At school age, children often have mild concussions in physical education lessons or while playing in the yard with their peers, however, due to practically no symptoms, parents are in no hurry to show their child to a doctor. The consequences of trauma begin to worry in adolescence in the form of a change in psycho-emotional mood, fatigue, etc.

How to tell if a child has a concussion: symptoms and signs

Disorders arising from the displacement of brain structures are temporary, as well as the intensity of symptoms. In children under 1 year old, it is difficult to recognize a concussion, since most of the symptoms that appear are neurological in nature. Most often, in a child of this age with a concussion, the following symptoms can be observed:

• pallor;
• anxiety and crying;
• regurgitation and full-fledged bouts of vomiting;
• drowsiness, and at the same time, restlessness of sleep;
• swelling of the fontanelle.

Symptoms in older children are closer to. In the first hours, their general condition changes, and the following symptoms occur:

The described symptoms should not be ignored by parents. If they appear, it is necessary to immediately take the child to the hospital or call the medical team home.

What to do in case of a concussion in a child, first aid

In the event of a fall, resulting in a blow to the head on a hard surface or a strong concussion of the body, you must immediately provide the child with emergency assistance and call a medical team. If the baby is conscious, then the parents should follow these steps:

Are you worried about something? Illness or life situation?

• restrict the child's movement by gently laying him on a hard sofa or bed on his side, bending his knees at the same time and placing his hand under his head;
• cover the baby with a blanket if he feels a chill;
• before the doctor arrives, do not let the child fall asleep, even if he is experiencing severe drowsiness;
• periodically check the baby's respiratory rate and pulse (in infants - in the forearm, in older children - in the carotid artery).

An unconscious child should be placed on a flat surface and checked to see if he is breathing. If the baby is not breathing, and signs of a lack of oxygen begin to appear, emergency assistance should be given to him - artificial respiration.

Immediately take the child to the hospital after an injury, without waiting for the medical team, in the following situations:

• as a result of hitting the head, the child has an open wound that bleeds for more than 15 minutes;
• in infants, the skin in the fontanelle area is swollen;
• blood or ichor-like fluid comes out of the ear or nose;
• the size of the pupils changes or their trembling appears;
• bothered by repeated bouts of vomiting;
• coordination of movements is impaired and speech becomes indistinct;
• muscle spasms appear, which lead to uncontrolled twitching of the limbs.

If the child is provided with timely and competent primary care, then the risks of consequences are minimized.

Diagnostics

Immediately after the injury, the child must be examined by a neurologist. If severe symptoms appear, indicating impaired brain function, it is necessary to involve a traumatologist and neurosurgeon for consultation.

Based on visual signs and complaints, the doctor determines which of the following painless and simple research methods will accurately diagnose a concussion in a child:

1. X-ray- prescribed for suspected fracture of the cranial bones. In infants, the bones of the skull are soft, and their fracture may have a hidden clinical picture. X-ray allows you to identify the slightest violations in this area in order to take prompt measures to eliminate them.
2. Echo encephalography- ultrasound method, during which the degree of displacement of the brain in relation to its initial position, as well as the presence or absence of hematomas in the structures, is revealed. Against the background of neurosonography and tomographic studies, the technique is considered outdated and is used only in cases where it is not possible to carry out diagnostics on modern equipment.
3. Neurosonography- a modern method of ultrasound, which allows examining the structure of the ventricles and medulla for the presence of edema, intracranial hematomas, vascular ruptures, which led to the occurrence of hemorrhages. The technique is most effective in detecting brain damage in children not older than 2 years of age, until the fontanelle is completely overgrown. In the future, with thickening of the bones of the skull, neurosonography is difficult to carry out and its result decreases.
4. Is a modern alternative to radiography. The method allows you to get a high-quality and clear image of not only the cranial bones, but also the medulla. The study diagnoses all degrees of brain damage - hemorrhages, fractures, hematomas, bruises.
5. MRI- the most accurate method for diagnosing cerebral concussions and at the same time the most expensive in terms of cost. With its help, skull injuries are not diagnosed, however, hematomas and intracerebral hemorrhages characteristic of a concussion are clearly recognized. The procedure requires the baby to be stationary for up to 20 minutes, which is very difficult to explain to babies. In such cases, it is quite often necessary to resort to anesthesia at the time of the diagnosis.

Electroencephalography (to study the activity of brain neurons) or lumbar puncture (to study the cerebrospinal fluid, changes in which may be caused by inflammatory processes or latent hemorrhages) can be used as auxiliary diagnostic methods for suspected severe intracerebral damage in children.

If a child is diagnosed with a concussion, he is admitted to a hospital to monitor his health. He is provided with complete rest and bed rest, while watching TV, noisy communication, listening to music, playing games on the phone and computer is prohibited.

Depending on the diagnosed disorders, the symptoms manifested and the age, the child may be prescribed one or more drugs:

• Diuretic or antihistamines - to prevent swelling of the brain tissue;
• Sedative agents - in order to calm the baby;
• Pain relievers - with severe pain syndrome;
• Antiemetic drugs - if the child is worried about repeated vomiting and nausea;
• Nootropics - to ensure optimal blood flow to the structures of the brain and its nutrition due to this;
• Vitamin complexes with a predominance of vitamins B, A and E.

All medications should be prescribed exclusively by a pediatric doctor, as well as herbal tinctures, if their use is appropriate. After discharge, the baby is usually prescribed physiotherapy and a gentle regimen.

Consequences after a concussion in a child

In most cases, the symptoms of a concussion in a child disappear after 3-5 days, the parents believe that the baby is recovering and stop treatment, returning him to his daily life rhythm. The consequences of such actions begin to manifest themselves much later - in adolescence and adulthood.

Depending on the severity of the injury and the type of disorders to which it led, the child may eventually develop the following complications and consequences:

The described disorders remain for life, reduce the quality of life and only get worse with age. To reduce the likelihood of their occurrence, you need to monitor a restless child at a young age and conduct conversations on basic safety rules with schoolchildren and adolescents. If a head injury does occur, the child should be taken to the hospital immediately and the recommendations of the pediatrician should be followed.

I often see posts in which mothers talk about their worries about hitting the child's head: hit, fell.
The responses in the comments are striking: “Yes, okay, don't worry ... All children fall! Mine fell a hundred times a day and nothing, normal. ”, - gy-gyyy.

I propose to figure out how "normal" a head injury is, even, at first glance, not significant ...

Concussion in children. Symptoms and Treatment

Concussion is one of the most common diagnoses in pediatric traumatology. In general, traumatic brain injury (TBI) ranks first among all childhood injuries requiring hospitalization. Approximately 120 thousand children with concussion are admitted to hospitals in Russia every year.

In terms of severity, traumatic brain injury is subdivided into mild (concussion), moderate (contusion of the brain of mild and moderate severity, with possible fractures of the bones of the cranial vault) and severe (contusions of the brain of a severe degree, intracranial hematomas with compression of the brain, fractures of the base of the skull). Fortunately, up to 90% of childhood TBIs are due to concussions, which will be discussed in this article.

The high level of injuries in children is explained by the child's increased motor activity, restlessness and curiosity, which is combined with imperfect motor skills and coordination of movements, as well as a reduced sense of danger and fear of heights. In addition, in young children, the head has a relatively large weight, and the skill of belaying with hands is not yet developed, so small children, as a rule, fall upside down and do not substitute their hands.

The causes of childhood TBI are very specific for each age group. Newborns in the total mass of victims account for 2%, infants - 25%, toddlers - 8%, preschool children - 20% and school age 45%.

Infant injuries are primarily the result of the neglect and carelessness of their parents. Children under 1 year old most often (more than 90%!) Receive head injuries after falling from changing tables, beds, from their parents' hands, from strollers, etc. You should never leave your baby alone in a place from which he may fall. If you need to move away from the child at a distance greater than an outstretched hand, do not be lazy, put him in a crib, in a stroller with sides, in a playpen! One or two seconds is enough for the baby to roll to the edge of the changing table and fall.

Starting out from 1 year babies begin to walk. The main cause of TBI is falling from a height of one's own growth, and a little later - falling from stairs, trees, roofs, windows, slides, etc. The episode of TBI itself is not always possible to identify. It should be borne in mind that if the child remained under the supervision of relatives, neighbors or a nanny, then they can hide the fact of the baby's fall from the parents.

Older children themselves, for various reasons, often hide the trauma. In addition, children may have brain damage without direct head injury. These injuries usually occur when a child's body is exposed to sudden acceleration or deceleration (“shaken baby” syndrome). Shaken Baby Syndrome is most commonly seen under the age of 4-5 years and can occur with rough handling, jumping from a height to feet, and in young children, even with excessively intense motion sickness.

Signs of a concussion

With a concussion of the brain, gross, irreversible changes do not occur in it, and such an injury, being the most frequent, has the best prognosis and very rarely leads to complications.

It should be remembered that the brain of a child (and especially of an infant) is significantly different from the brain of an adult. The picture of concussion in adults differs significantly from the course of this trauma in a child.

In adulthood, a concussion is manifested by the following main symptoms: an episode of loss of consciousness from a few seconds to 10-15 minutes; nausea and vomiting; headache; amnesia (loss of memory) of trauma-related events (before the injury, the injury itself, and after the injury). In addition, some specific neurological symptoms are revealed, such as nystagmus (twitching of the eyeballs), impaired coordination of movements, and some others. The picture of a concussion in a child is completely different.

In children up to 1 year concussion, as a rule, is asymptomatic. Loss of consciousness often does not happen, there is a single or repeated vomiting, nausea, regurgitation during feeding, pallor of the skin, causeless anxiety and crying, increased drowsiness, lack of appetite, poor sleep.

In children preschool age more often it is possible to establish the fact of loss of consciousness, nausea and vomiting after injury. They have headaches, increased or slowed heart rate, instability of blood pressure, pallor of the skin, sweating. At the same time, moodiness, tearfulness, and sleep disturbances are often noted.

Sometimes children experience a symptom such as post-traumatic blindness. It develops immediately after injury or a little later, persists for several minutes or hours, and then disappears on its own. The reason for this phenomenon is not completely clear.

The peculiarities of the child's body lead to the fact that a long-term state of compensation can be replaced by a rapid deterioration of the state. That is, immediately after the fall, the child feels satisfactory, and after a while the symptoms appear and begin to rapidly increase.

First aid for TBI

What should a parent, whose child has received a head injury, do? There is only one answer - the child should be shown to the doctor without fail and urgently. It is best to immediately call an ambulance, which will definitely take the child to a hospital that has pediatric neurosurgeons or neuropathologists. And this measure is not superfluous. With minimal symptoms and complaints, the baby may have severe brain damage. Long-term visible well-being of the child, the absence of symptoms, especially with hemorrhages in the brain, often after a few hours or even days, it is replaced by a progressive deterioration of the condition, which begins with a change in the child's behavior, his increased excitability, there may be nausea, vomiting, nystagmus, the fontanel bulges in infants , then drowsiness appears, depression of consciousness is observed.

Diagnosis of a concussion

In the hospital, the child is examined by a pediatric neurologist, neurosurgeon or traumatologist. He thoroughly investigates complaints, collects anamnesis (history of the disease), conducts a general and neurological examination. Additional diagnostic methods are assigned. The main ones are X-ray of the skull, neurosonography (in young children), echo-encephalography (Echo-EG). If necessary - computed tomography of the brain (CT), magnetic resonance imaging (MRI), electroencephalography (EEG), lumbar puncture.

X-ray the skull is carried out by most of the patients. The purpose of this study is to identify skull fractures. The presence of any damage to the bones of the skull automatically translates the injury into the category of moderate or severe (depending on the condition of the child). Sometimes in young children with a successful clinical picture, linear fractures of the skull bones are revealed on radiographs. It is impossible to judge the state of the substance of the brain by radiographs.

Neurosonography(NSG) is an ultrasound examination of the brain. The neurosonograms clearly show the substance of the brain, the ventricular system. Signs of cerebral edema, bruises, hemorrhages, and intracranial hematomas can be detected. The procedure is simple, painless, quickly performed, and has no contraindications. It can be repeated many times. The only limitation of neurosonography is the presence of so-called "natural ultrasound windows" - a large fontanelle or thin temporal bones. The method is very effective in children aged up to 2 years... Later, ultrasound becomes difficult to pass through the thick bones of the skull, which drastically degrades the image quality. Neurosonography equipment is available in most children's hospitals.

Echo encephalography(Echo-EG) is also an ultrasound method of investigation, which allows to reveal the displacement of the structures of the midline of the brain, which may indicate the presence of additional volumetric formations of the brain (hematomas, tumors), give indirect information about the state of the brain matter and the ventricular system. This method is simple and fast, but its reliability is low. Previously, it was widely used in neurotraumatology, but with modern diagnostic tools such as neurosonography, computed tomography and magnetic resonance imaging, it can be completely abandoned.

The ideal method for diagnosing brain damage and diseases is CT scan(CT). This is an X-ray examination method in which images of the bones of the skull and brain matter can be obtained with high definition. By CT, almost any damage to the bones of the vault and base of the skull, hematomas, bruises, hemorrhages, foreign bodies of the cranial cavity, etc. are diagnosed. The accuracy of this study is very high. Its main disadvantage is that the CT machine is expensive, and it is not available in every hospital.

Magnetic resonance imaging(MRI) is the most accurate, but difficult and expensive method of examining the central nervous system. It is rarely used to diagnose acute traumatic brain injury, since it does not allow seeing the bones of the skull, is less accurate for recognizing acute hemorrhages, takes longer than computed tomography, and often requires anesthesia when examining young children - the child must lie absolutely still for 10 -20 minutes, but small children cannot do this; in addition, very few clinics can boast of the presence of magnetic resonance imaging machines.

Electroencephalography(EEG) allows you to study the bioelectrical activity of the brain. It is used for special indications to assess the severity of traumatic brain injury, to identify foci of epileptic activity. The focus of epiactivity is an area of ​​the cerebral cortex with pathologically altered activity of neurons (nerve cells), which can lead to epileptic seizures.

Lumbar puncture- This is the collection of cerebrospinal fluid (fluid that washes the brain and spinal cord) from the spinal canal at the lumbar level. Changes in cerebrospinal fluid may indicate trauma or hemorrhage (presence of blood) or an inflammatory process, meningitis. Lumbar puncture is extremely rare and only for special indications.

Concussion management

After the baby has fallen, before the doctor examines him, helping the baby is to create a calm environment. It is necessary to put the baby to bed, to provide him with peace. If there is bleeding from the wound, treat and bandage it if possible.

In addition to diagnostic procedures, in the emergency room of the hospital, the treatment of soft tissue injuries of the head (bruises, abrasions, wounds) is carried out. Children, especially young children, with confirmed craniocerebral trauma, including concussion, are subject to compulsory hospitalization.

Hospitalization has several purposes.

First, for several days the child is under the supervision of doctors in a hospital for early detection and prevention of complications of trauma - cerebral edema, the appearance of intracranial hematomas, epileptic (convulsive) seizures. The likelihood of these complications is small, but their consequences are extremely serious and can lead to a catastrophically rapid deterioration in the child's condition. Therefore, with a concussion, the standard hospital stay is a week. With good technical equipment of the hospital (computed tomography, neurosonography), which makes it possible to exclude more severe brain damage, the length of stay in the hospital can be reduced to 3-4 days.

Secondly, during hospitalization, the patient is provided with the creation of psychoemotional rest. This is achieved by limiting the child's motor and social activity. Of course, it is difficult to achieve complete bed rest for children, but nevertheless, the conditions of the hospital do not allow running, noisy games, long TV viewing, sitting at the computer. After discharge, the home regimen is maintained for another 1.5-2 weeks, several weeks are limited to sports.

Concussion medication serves several purposes. First of all, the child is prescribed diuretics (most often, less often -) in a mandatory combination with potassium preparations (,). This is done to prevent edema of the substance of the brain. A sedative therapy is carried out (PHENOSEPAM, VALERIAN'S NATURAL ROOT) and antihistamines are prescribed (,). For headaches, analgesics are prescribed (BARALGIN, SEDALGIN), with severe nausea -. At a later date, nootropic drugs may be prescribed that improve metabolic processes in the brain, vitamins.

The control over the condition of children is carried out by the attending physician and the doctor on duty, as well as by the sentry nurses. In case of any deterioration, the child is re-examined, additional diagnostic tests are prescribed (neurosonography, computed tomography, EEG).

When offering to go to the hospital, the doctor first of all takes care not to miss a trauma that is more severe than a concussion, and this is possible only with qualified supervision of the child.

If the baby is in a satisfactory condition, after a few days, the parents can take him home on receipt. However, at home it is also required to observe a medical and protective regime, limit watching TV, playing games on the computer, walking, visiting friends, and continuing drug therapy. If you suspect a worsening of the child's condition (the appearance of nausea and vomiting, headaches, unmotivated drowsiness, seizures, weakness in the limbs, frequent spitting up in babies), you should immediately consult a doctor again for further examination and possible hospitalization.

As a rule, after 2-3 weeks, the child's condition completely returns to normal. A concussion usually goes away without consequences or complications. The child can again attend nurseries and kindergartens, and play sports.

In conclusion, once again, it is necessary to emphasize the importance of timely treatment in a specialized children's hospital, which will allow to exclude more severe forms of traumatic brain injury.

How dangerous is a concussion for mental activity, the nervous system?

Concussion is a functional injury. The basis is not the destruction of neurons, but a temporary disruption in the functioning of the brain.

If the regimen is observed and there are no aggravating factors (the presence of concomitant diseases of the nervous system), the concussion ends with recovery. Otherwise, a concussion received in early childhood will affect adulthood, especially during the years of study: school, institute - not attentiveness, not perseverance, learning difficulties, difficult assimilation of material, memory ... Often parents perceive this as laziness and parasitism, and blame for all the once untreated concussion!

A concussion is considered a minor injury, but can there be a long-term complication of a concussion? Which?

In some patients, over time, there may be a weakening of attention, memory loss, dizziness, headaches, fatigue, sleep disturbance. And also, decreased vision, hearing loss, speech inhibition. There are known cases of death from not referring to doctors with traumatic brain injury.

However, about a year after the concussion of the brain, these signs disappear or are significantly smoothed out.

As a rule, these changes occur in patients who already suffer from certain diseases of the nervous system.

If the recommended treatment regimen is not followed, the recovery period is lengthened and asthenic syndrome, vegetative vascular dystonia and other disorders may occur.

Although in some cases, long-term consequences may occur. This is meteorological dependence, and even epileptic seizures.

Therefore, it is necessary to take the injury seriously and at least 2-3 days after it, make the child lie down, even though he feels good. Ideally, you should contact a doctor within the first 24 hours from the moment of injury (!), In order to efficiently localize the consequences of a brain injury in a timely manner.
----

Personal experience

Recently (06/11/16) we were admitted to the hospital with a concussion: in the kindergarten (06/10/16), in a group, after lunch and before a quiet hour, mine was playing with a stroller and a doll ... A boy and 2 girls came up, began to take away ... As a result, a boy with one of these girls pushed mine so that she fell on the carpet along with the stroller - the first bump. Immediately the second girl came up to my lying one and bit her on the forehead, in the hairy part - the second bump. There was no one among the educators, both teachers (one from the first shift, had not left yet and the second from the second shift, had already come) washed the dishes in the kitchen and talked peacefully. The nanny came running first to the screams. Mine could not get up on my own due to severe dizziness and darkening in the eyes. The nanny took mine in her arms and felt sorry for me ... My daughter cried a lot and could not calm down for a long time. The educators punished the culprits of the conflict - they scolded them, put them in a corner.

I came to pick up mine right after a quiet hour (Friday, our last day in kindergarten, before the holidays), the teacher and nanny did not tell me anything. We immediately went to the dacha. All the way the daughter behaved restlessly, whimpered and constantly scratched her head. I thought: whimpering with fatigue, itching head - itching (right now, I already understand that my head ached). In the morning I woke up at 07:00 - earlier than usual (usually, if you don't need to get up early in the morning, you can wake up at 08:00 at the earliest, and even sleep until 10:00), and with crying began to complain of pain in the head. My headaches do not suffer and I immediately assumed that perhaps she fell or hit her head in the kindergarten. I started asking her ... My daughter showed me her bumps and told me everything. I asked her what she hadn’t told me yesterday ... My daughter replied that yesterday, as everything happened, it hurt very badly, but then my head began to hurt less, and my head hurt less so much as today ... My husband and I made a decision to go to Moscow, to show ourselves to doctors.

We arrived at the emergency room, did an x-ray of the skull - approx. The traumatologist recommended to observe for 3 days and, after that, show the child to the Neurologist, regardless of the child's condition. This recommendation of the Traumatologist did not suit me - to wait 3 days ... And as soon as we arrived home, they immediately called an ambulance, they recommended that we go to the hospital immediately, and my daughter and I went to the Children's City Hospital No. 9 in the ambulance. Dad followed us in a car ...

In the hospital, in the admission department, I told the Pediatrician, in addition to everything, about the recommendations of the Traumatologist from the Trauma Center ... The pediatrician was outraged by this recommendation - to wait 3 days ... He said that I did the right thing, that I did not wait ... within the first 24 hours from the moment of injury, go to an ambulance, because traumatologists look, only bones and visible damage to soft tissues, they cannot see the brain and assess its condition, this requires a comprehensive examination of several specialists, M-Echo , observation ..., in a hospital environment ! My condition upon admission was determined as moderate, noted hematomas of soft tissues and took blood for analysis. The doctors asked me - did I report to the police? I say no. Why are they? I explained ... They warned me that they would give a signal to the Police - to protect the rights of the child, because I myself did not say ...
Made M-Echo in dynamics (3 days in a row) - approx.
Examined by a Neurosurgeon and a Neurologist - approx.
Examined by the Oculist - dilated veins of the fundus(an indirect sign of a concussion).

The next day of my stay in the hospital, the district police officer calls, says the case will be transferred to the Inspector for Juvenile Affairs, and when they call me, she should come for interrogation.

They lay there for 5 days.
During this time, they took:

• - 1 volume x 3 rubles / day;
• Asparkam - 1/2 t. X 2 rubles / day;
• Diakarb - 1/2 t. X 2 rubles / day

- All medications are prescribed taking into account the age of the child.

In the hospital, my daughter and I lay together - p

Alata is designed for 2 children and 2 parents, 1 parent for each child.The food was good, my daughter speaks deliciously, like in a kindergarten ... With us in the ward, with the same diagnosis, a 5-year-old girl was lying - she fell off her bicycle. We entered together and were discharged together.

• Follow-up by a Pediatrician and a Neurologist at the place of residence.
• Glycine- 1 volume x 3 rubles / day - 3 weeks
  
• Rest: restriction in physical activity (you can not: run, jump, ride on carousels and downhill, rides ... If we were on vacation, visit kindergarten / any children's groups, here too), as well as the complete exclusion of work on electronic media (not allowed: TV, computer, tablet, iPhone ...) - 3 weeks
• Avoid direct sun, cover your head with a panama hat.
• Exclude air travel - 6 months

E-eh ..., just like looking into the water ...:
Immediately after I was discharged from the hospital, the Inspector for Juvenile Affairs called me and invited me for interrogation. Under interrogationFirst of all, the Inspector for Juvenile Affairs demanded an explanation from me why I did not report what had happened, why the doctors did it for me ... - I had to record the explanations ... From the child's words, they recorded everything in detail, signed ... They said that a check would be carried out in the garden , work will be carried out among all the staff of the kindergarten, parents and children participating in the conflict, of course, taking into account that the protocol was drawn up on the basis of the words of the four-year-old. Here the Inspector and I made a decision and signed a petition, according to which I ask the children not to be interrogated due to their unconscious age, so as not to affect their psycho-emotional state, but to interrogate their parents, so that the parents themselves would conduct educational conversations with their children, during avoiding a repeat of such a conflict ... Also, since the child received timely medical assistance, there is no longer any threat to his life and health, we signed a petition on which I ask to close the case.
I was very pleased with such attention towards children, I feel care and responsibility for our future - children, from doctors and authorities ... I became confident that after the work done, something like that in the kindergarten (God forbid) will not happen again. 06/20/16 were taken from the Pediatrician by referral to the Neurologist to register - we will be observed ...

06/21/16 registered with a Neurologist ...
My daughter and I came to the Neurologist, and I said to her: "We have a concussion, we just left the hospital ...", - I hold out our extract.
She took the extract, looks, and says: “Where did you see that you had a concussion !?”, hands me the extract ...
I with rounded eyes ...: "How ... Wasn't there something? We were in the hospital, they kept us for 5 days, the recommendation says to register with you to get up ... ”- that is, in my worries, I didn’t even notice the fact that there was not a word about concussion in our discharge brain.
To which she replies: “You have a soft tissue injury. And that you were in the hospital and came to me ... - this is a standard procedure for all children who have been admitted with a complaint of a blow to the head, in order to be monitored and to exclude a concussion ... ", in general, doctors will be reinsured. Yes, I do not mind, only "FOR" reinsurance!
Of course, I am very glad that we got off so lightly, but my daughter still suffered, so let the police figure it out ... so that such incidents will not happen again either with mine or with the other kids in the group.

In the direction of our Neurologist, a month after being discharged from the hospital, we appeared to the ophthalmologist to check the veins of the fundus - ok, they have already returned to normal. Along with this, at the same time, she carried out a full examination of vision - approx. Recommended "quarantine" on TV, tablet ... to extend for another 2 months. As she explained ... - despite the fact that the veins of the fundus have already fully recovered, after such an injury there may still be residual effects ... - in general, the eyes still need rest. After 2 months. TV, tablet ... strictly limited! Watching "Good night" before bed is enough. She gave me a memo "Communication" of a child with a TV, a computer ... by age group, so that we go to school with good eyes. She stressed that the main % all children are already going to the first grade wearing glasses because of the uncontrolled "communication" with electronic equipment.

On the back of the memo there are sites where you can read information about vision, eyes, where to go ...:
www. detskoezrenie.ru
www. eye-focus.ru

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Health to yours and our children! After all, children are the most precious, most invaluable thing we have - our future!

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P. S .: Oh virgins, I've seen enough in the hospital for babies with puncture for trauma ... One is not even a month old, the other is 2 months, 3-4 months ... Horror, already with holes in the head! I’m curious - it wasn’t clear to me, HOW such a kid, who still cannot turn over on his own, can fly off the couch, for example !? I talked with one doctor ... She says, "How, how ... The child is crying, the mother's nerves are giving up and she throws him on the floor ... - postnatal depression." a phenomenon that is already normal to this, I'm used to it ...
And I think something like that is very rare ...:

Hmm, I also once gave birth, I also had this post-natal psychosis, I felt like I was not myself for half a year ... But I didn't even think of throwing my head on the floor ... She thrashed the pillow with a psycho, when it covers it - yes, I hit my husband 2 times with fists pounced on ... - the poor, silently endured everything. But the child on the floor ...

I'm not judging anyone! Emotions pour ...