The article was consulted professionally by Specialist I Do Van Manh – Emergency Resuscitation Department – Share99 Ha Long International Hospital.
Traumatic brain injury is a traumatic condition in the head that damages the skull and other internal structures. Without proper treatment of traumatic brain injury, the victim is very likely to die or experience many severe symptoms.
1. Overview of traumatic brain injury
Traumatic brain injury is a life-threatening risk, especially trauma in children is always a potential danger. The main causes of traumatic brain injury include:
- Traffic accidents.
- Occupational accidents.
- Living accidents.
- Accidents in the event of a disaster.
- Careless accident.
- Accidents caused by playing sports.
- Head injury at birth…
There are two common types of cranial damage assessment:
- Closed traumatic brain injury: There is traumatic brain damage but has not caused a torn sural membrane, has not been able to open the brain to the external environment. Skull damage can subside, skull fractures, concussions, brain tremors, hematoma brain compression, cerebral edema, gas overflow…
- Open traumatic brain injury: Causes epidural tearing, opens the brain to the outside and is at high risk of brain infection.
There are also many other ways of categorising traumatic brain injury complications such as by nature or location of brain damage, to khunial and spreading brain trauma or appearing both types at the same time.
2. Symptoms of traumatic brain injury
The mechanism of traumatic brain injury is caused by a direct hit to the head. Depending on the place of the collision, the velocity and the cause of the injury will lead to symptoms varying from mild to severe. In general, symptoms of traumatic brain injury usually manifest through two bodies:
2.1. Minor injuries
Injuries immediately after an accident, with specific manifestations at the place of contact include:
- Lacerations to the scalp cause a lot of blood loss.
- Fracturing the skull in the bird's leg, or subsidence inserted into the meninges and brain organization.
- Damage to the meninges causes encephabrospinal fluid discharge.
- External and sdydural hematoma, bleeding in the brain.
- The brain organization is stamped or escaped.
There are also lesions associated with inerction caused by the skull being shaken or twisted, the head is mobile so the brain is subjected to sudden acceleration / acceleration. This condition damages the pervasive axis causing the victim to have a prolonged coma, while sub-clinical symptoms are much more severe.
2.2. Minor injuries
Formed after an accident occurs, including:
- Hematoma in the skull: Blood flowing out accumulates in mass, causing room in the skull and increasing in-skull pressure, causing brain cell damage.
- Cerebral edema: Damage to the blood-brain barrier and cell membranes leads to abnormal accumulation of water in the interstitial organization and in the cell.
- Dilinal dility: Bleeding clotting the circulation of cerebral water.
3. Emergency traumatic brain injury
3.1. When to be admitted to the hospital?
In case of a head injury, parents should take their child to the hospital immediately if they see that the child has one of the following signs:
- Unconscious for more than a minute immediately after the fall.
- Still conscious after the collision but then appearing abnormal signs such as: difficulty crying, sleeping a lot, neglect, poor interaction or unconsciousness;
- Vomiting more than 5 times or vomiting lasts more than 6 hours after a head injury.
- The swelling is bulging, stretched, accompanied by a pale face.
- There are injuries elsewhere, there is a lot of bleeding.
In adults may appear additional manifestations such as confusion or decreased hearing, prolonged headache and vomiting, mental disturbances, ,…
3.2. Care Plan
- Emergency and immediate care upon admission
Immediately after the injury, the victim must be given a timely emergency, quickly transferred to the nearest medical facility for initial treatment, then taken to a neurosurgery specialties.
- Comprehensive search
A comprehensive examination is required when the victim arrives at the emergency room, especially if there are multiple injuries such as internal bleeding, pleural hemorrhage, pelvic rupture, femur fracture …
- Emergency and airway priority
Neurological examination should be in order: Sense, nerve marks positioning, biomarker (pulse, blood pressure, temperature and breathing). The victim's breathing and re ability must be controlled.
- Determination of diagnosis and selection of treatments
Examination and re-evaluation of clinical and sub-clinical lesions. Treat traumatic brain wounds as soon as possible to avoid blood loss and bacterial infections.
3.3. Emergency priority
- Fix the cervical spine while waiting for X-ray results.
- Ventilating the airways by sucking the water in the mouth and through the nose.
- In-administration or opening of the insym management when there is a rupture of the jaw bone.
- Ensure adequate ventilation and breathing.
- Control bleeding and circulation;
- Active shock treatment to improve brain perfusence.
- Prevent external bleeding (if any).
- Rapid evaluation of neurological marks.
In general, all initial examination and treatment of victims must be carried out in parallel. For inranranial hematomas that cause brain compression, emergency surgery is required immediately after detection to clear the brain. If the victim has suffered from impaired sense, one-party dilation of the homage or paralysis, then the emergency treatment of a late traumatic brain injury will be life-threatening.
3.4. Sub-clinical in dinh
- X-ray of the skull: Bone surface, cranial subsidence, cracked lines, skull fractures,…
- CT scan of the head: Weakness, heporial paralysis, blindness, dizziness, confusion, prolonged headache and vomiting, contuscage, fracture of the skull bone,…
In addition, patients who want to assess the patient's potential must perform a full range of electroencephalus tests (EEG), cerebral vessels (DSA) or cerebral vascular Doppler. In order to minimize the level of disability left by the testament, the patient is forced to undergo a long-term rehabilitation process.
In general, emergency treatment of traumatic brain injury is a top priority and must quickly clear the airways. The doctor also needs to comprehensively assess all injuries to avoid omission, affecting the hope of curing the patient. For victims who do not need to be admitted to a compulsory hospital, a specialist's instruction is required for convenient monitoring at home.
Specialist I Do Van Manh has more than 10 years of experience in the field of Active Resuscitation – Anti-Toxicity. He served as deputy head of the Active Resuscitation Department of Quang Ninh General Health Hub before working at Share99 Ha Long International Health Hub.
Customers can directly go to Share99 Health System nationwide for medical examination and treatment or contact to make an appointment online HERE.
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