Nuchal contusion is a large and heterogeneous group of injuries with an incidence of 100–500/100,000 inhabitants per year. During life, these lesions are registered in 3.7% of men and 2.4% of women. The increase in head and cervical spine injuries is explained by civilizational factors: 45% of injuries are due to road accidents, 30% to falls, 20% to professional and sports injuries. Why can’t you hit the back of the head, why are such injuries dangerous?
Types of injuries sustained after impact
Painful sensations after a blow can manifest themselves in different ways. The injuries that led to the pain in the head can also be different.
The most common head injuries caused by impact include:
- injury;
- hematoma;
- fracture;
- wounds.
Pain can occur from bruising of different parts of the head. It can touch the scalp, face, nose, and jaw.
Helpful information
But the most dangerous is considered to be a brain contusion. Depending on the severity, the patient loses consciousness and exhibits many unpleasant symptoms.
This type is also characterized by the occurrence of hematomas.
There are three types of hematomas: epidural, subdural, intracranial. The first occurs under the skin, without much damage to the structure. The second is characterized by a violation of the intramuscular space, and the third is inside the skull.
Fractures may involve the cheekbones, nose or eye socket, or the skull as a whole. Mechanical damage such as wounds comes in several varieties: punctures, lacerations, cuts, bullets.
Special case: children were injured
Parents are not always able to find out in time that their child has hit his head. Signs of a concussion include increased activity. The incidence of brain injury in children is much higher than in adults, due to curiosity and poor coordination. Very rarely, a child can adequately assess the level of danger of a situation. The younger the child, the worse his head protection reflexes are, which means that a fall with a greater degree of danger can provoke a TBI.
The signs of a head concussion in an infant or small child differ from the manifestations of a brain injury in an adult. The younger the child, the less pronounced the symptoms. Victims very rarely lose consciousness. You can suspect an injury based on the child's anxiety and tendency to cry. The baby spits up, vomits frequently, the skin turns pale, and the appetite becomes worse. If an infant is injured, the fontanelle may swell. Some children cannot sleep, others are constantly drawn to sleep. But at school age, those injured lose consciousness more often than infants. At this age there is already a danger of minor amnesia. The child complains of a sore head, sweats profusely, is apathetic or irritable, capricious, and prone to crying. Checking the pressure shows instability.
Symptoms that occur after a head impact
If you have a headache after a blow, you should pay attention to the accompanying symptoms. They can often tell you more about the resulting consequences.
After the blow occurs, a hematoma forms at the injured site. In this case, painful sensations are located at the site of injury. This is a case that does not require a trip to the hospital - it can be solved at home.
If the damage is severe, bleeding occurs. It is often difficult to stop it on your own. In this case, the pain only intensifies, dizziness and nausea are noted.
If a person has the following symptoms, you should immediately call an ambulance:
- clear or bloody discharge from the nose and ears;
- temperature rise to 38 degrees;
- drowsiness;
- confusion;
- loss of consciousness;
- the presence of additional injuries on the back, in the occipital region;
- speech disorder;
- inability to focus on one point;
- change in pupil shape;
- labored breathing.
Depending on the severity of the injuries received, the manifestation of symptoms will be appropriate. If a characteristic symptom is nausea with vomiting, then in a mild form it will be one-time and short-term, and in a severe form it will be long-term.
It is important to remember that if the patient has severe symptoms, he should not be moved independently. This is fraught with complications.
What else should I use?
After a brain injury, medications that reduce the formation of free radicals in organic tissues help stabilize the condition. Among pharmaceutical drugs, the popular “Glycine” has this effect. The medicinal compositions Mexidon and Mexiprim are known to have similar qualities.
Stabilization of the condition is possible by installing a dropper. A solution of electrolytes is injected into a vein. This is especially true for severe types of concussion. The program is designed to normalize the concentration of potassium ions in brain cells.
If an injury causes asthenia, if the patient is dizzy, the doctor may recommend B vitamins. Vestinorm and Betaserx show a good effect.
First aid
A headache after a blow, if it was severe, is difficult to relieve only by taking painkillers. If a person has been seriously injured, he must be given first aid until specialists arrive. The reason is that the impact could cause a fracture, which, in turn, would injure the brain. And the faster medical assistance is provided, the easier the consequences will be.
In a situation where the victim is unconscious and has no pulse, it is necessary to perform a cardiac massage with artificial respiration. If there is a pulse, place him on his side so that if he vomits, he will not choke on the vomit.
The conscious patient should be laid down, unfastened the top buttons and not touched until the ambulance arrives. You should not try to sit the person down or lift their legs, as serious injuries may make them worse.
These recommendations are relevant for visible traumatic brain injuries. If we are talking about hematomas, abrasions, apply a cloth soaked in cold water or ice wrapped in it to the injured area. If a wound is bleeding, it is worth treating it with brilliant green and iodine so that infection does not get there. Apply a gauze napkin to the wound and bandage it.
If there are pieces of a foreign body sticking out in the head, you cannot remove them yourself, as you can disrupt the structure of the brain, which will lead to serious complications. In this case, a cotton pad with gauze is placed around the protruding fragment to stop the bleeding. Upon arrival of the ambulance, transport the victim only in a supine position.
Pharmacy products: what will help?
If it is necessary to correct the condition after an injury or concussion, Phenobarbital may be prescribed. The drug belongs to the class of sedatives, improves falling asleep and sleep. The well-known drug Finlepsin has a similar effect.
People who have suffered trauma are prescribed drugs that prevent convulsions and inhibit reticular formations. The most accessible medications in this group are hawthorn and motherwort tinctures. Sometimes the doctor advises you to stop on Nozepam or Phenazepam tablets. The drug Phenibut has proven itself well, having a pronounced sedative effect.
To minimize tissue swelling and expand the vascular passages, people who have suffered a shock should take Sermion or Eufillin. The doctor chooses a specific drug based on the severity of the condition, indications and contraindications, and individual characteristics of the body. Sometimes the doctor advises stopping at Trental or Cavinton. The drug “Memoplant” has a good reputation.
When should you see a doctor?
You should seek help if the headache after a blow does not go away for a long time and is accompanied by additional unpleasant symptoms. Even if we are talking about an ordinary bruise, you should not neglect it.
Signs of a concussion may not appear immediately, but over the next two hours. Lack of help and refusal to go to the hospital will lead to complications, where the most dangerous outcome is the death of the patient.
Likely consequences
A head injury is fraught with life-threatening consequences, which include the following:
- Formation of brain cysts;
- A state of “waking coma”, in which the victim is conscious, but remains indifferent to his surroundings and is able to respond only to painful stimuli;
- Meningitis;
- Paresis;
Dear readers, in the video below we will talk about the symptoms and treatment of meningitis:
- Post-traumatic hydrocephalus;
- Increased intracranial pressure;
- Chronic headache;
- Formation of abscesses in the brain;
- Epilepsy.
The consequences of a head injury may not appear immediately. In medical practice, there are cases when they occurred in an adult who received trauma to the brain tissue or bones of the skull as a child.
The older a person is, the slower the recovery process is and the higher the likelihood of developing dangerous complications. In older people, a head injury can cause disability.
Treatment
The therapeutic approach in each case will be different, since there are also many causes of cephalalgia due to trauma. In addition to targeting the elimination of painful sensations in the head, therapy involves the weakening of secondary symptoms.
If you have a headache after a blow, medications are often used to:
- restoration of blood vessel tone;
- normalization of blood flow;
- stopping blood;
- eliminating the inflammatory, infectious process;
- lowering blood pressure levels;
- pain relief.
In addition to medicinal solutions to the problem, the victim must be provided with rest. It is also not prohibited to use alternative medicine options. To relieve headaches. Use cabbage or potato juice. But, despite their apparent harmlessness, you should consult a doctor before use.
In some cases, treatment cannot be done without surgery. For example, an open head injury indicates a rupture of the hard shell, which performs a protective function. The operation will help eliminate this defect and save you from death.
Features of therapy
In most cases, the condition returns to normal within the first week after injury or twice as long. On average, every third case is accompanied by complications of varying severity. The risk of such development is higher if you endure the condition on your feet. Possible post-traumatic neurosis. TBI can trigger epilepsy. A certain percentage of victims require urgent surgery.
In old age, there is a high probability of neurological symptoms and complications that worsen the functioning of the cerebral vascular system. Against the background of an injury, blood pressure may rise, the risk of stroke increases, and the risk of developing Alzheimer's disease increases.
If a person has suffered a concussion, they are placed under observation for the next year. The neurologist checks whether there are any consequences of the injury and how the quality of life changes. If necessary, the doctor recommends a course of treatment.
Why is a headache after a blow dangerous?
If you do not provide first aid and do not go to the hospital, the patient will face serious complications. They concern not only increased symptoms, but also organic disorders.
Therefore, if you have a headache after a blow, you should not ignore the manifestations of your body, otherwise the following is possible:
- disturbance in perception;
- absentmindedness;
- feeling of tightness in the head;
- decreased efficiency;
- frequent migraines;
- mental deviations.
After injury, swelling and bleeding occur, which contribute to the development of paralysis. The most severe consequence after trauma is falling into a coma or death. The second occurs in the case of severe and profuse bleeding in the brain, which leads to disruption of body systems such as the respiratory and cardiovascular systems.
Painful sensations after trauma indicate possible disorders. Depending on its severity, treatment is selected that will be aimed at eliminating the consequences of the blow, as well as improving well-being.
Terms and phenomena
Before considering what are the signs of a head concussion in a child and an adult, you should refer to the accepted terminology. Brain concussion is the name given to damage to organ tissue, nervous and vascular systems, membranes, and bones. This can happen due to an unsuccessful fall or impact on a hard surface. Irreversible consequences are possible. There is no precise description of the processes occurring in the brain after an impact. Doctors believe that a concussion leads to dysfunction of individual cellular nerve structures, disruption of tissue nutrition and displacement of the layers of the brain relative to each other. Microscopic bruises and swelling form, and blood penetrates from the vessels into nearby tissues. MRI does not show any significant changes in the morphology of the organ.
If signs of a head concussion in an adult or child suggest a severe course, there is a possibility of serious damage to individual elements of the brain. Blood vessels may rupture. This results in loss of consciousness for seconds or even minutes. The duration of unconsciousness allows us to assess the severity of the injury. Coma indicates the worst-case scenario.
Traditional medicine and the consequences of injury
Minor bruises can be treated at home. For this purpose, natural remedies are used, which quite often replace traditional medicine:
Even though treatment at home is safe, the patient should still visit a medical center to avoid complications.
In addition, you need to remember that treatment with folk remedies in severe cases is ineffective, for example, a brain contusion cannot be cured at home, and besides, precious time is lost when treatment can bring the greatest benefit.
If the pathology is treated incorrectly, quite unpleasant complications can occur:
A head injury can have various manifestations and stages, however, even with mild damage, it is better to consult a specialist on how to treat the injury in a particular case. For this purpose, medications or traditional medicine may be used. With such complex therapy, the outcome of the disease is usually favorable.
The temple is one of the weak points of the skull. Deep under the temple is the artery of the brain membrane. The average thickness of the skull is 5 millimeters, in the thickest place it is 1 centimeter thick, in the temple area the thickness of the skull is only 1-2 millimeters. A blow to this area can cause a concussion, loss of consciousness and death.
A blow to the base of the skull.
The point is located at the base of the skull, at the junction of the back of the head and the first cervical vertebra. A weak blow to this area leads to loss of consciousness, a strong blow interrupts the nerve and leads to immediate death.
A blow to the top of the head.
The point is located at the top of the head. This is a rather weak spot in the skull. A weak blow to this point can cause a concussion. A strong blow can damage the brain, cause hemorrhage and ultimately death.
Hit to the back of the head.
This point is located in the center of the back of the skull at the junction of several bones and can be felt as a slightly elongated structure. This cavity is the weak point of the head. With a weak blow to this point, a concussion and loss of consciousness occurs. If the blow is strong, it can lead to hemorrhage and death.
A blow to the brow ridge.
These points are located above the eyebrows. Blood vessels and nerves pass through these areas. A moderate blow can damage them and cause bleeding in the eyes and loss of consciousness.
A blow to the lower jaw.
This point is located at the corner of the jaw below where it articulates with the ear. A blow to this area breaks the bone into small pieces. This area is also known as the "knockout area" because a side kick aimed at it strikes the cervical spine, causing the opponent to fall. This is one of the reasons why in real combat fighters often lower their chin to cover the point of the lower jaw.
A blow to the nasal bone.
This point is located on the nasal bone, between the eyebrows. The nasal bone is thick at the top and thins at the bottom; there is a small vein in the center that goes to the nasal cavity. A blow to this area can easily damage the nasal bone and lead to severe bleeding and difficulty breathing. In addition, a blow to the nose is very painful and impairs vision.
Hit to the cheek (above the side of the jaw)
This point is relatively weak. A blow to it leads to a fracture of the jaw and damage to surrounding blood vessels and nerves. If the opponent's mouth is open and the blow is struck at a downward angle, the jaw will fall out of its socket, causing severe pain.
A blow or slap to the ears.
There are many blood vessels and nerves running near the ears. A blow to the ears damages the outer ear and eardrum.
The most vulnerable points of the neck.
A slash to the back of the neck.
This point is located near the third vertebra of the neck. A slight blow to it causes displacement of the vertebrae, which as a result puts pressure on the spinal cord. A medium-strength blow will knock out the opponent and can lead to serious complications. A strong blow that interrupts the nerves of the spine leads to immediate death.
Slash to the throat (thyroid cartilage)
The thyroid cartilage (in common parlance, the Adam's apple) is surrounded by numerous blood vessels and nerves, and behind it is the thyroid gland. A blow to the throat causes severe pain and loss of the ability to breathe. If the opponent's head is tilted back when striking, the result of the impact will be much greater.
The most vulnerable points of the torso.
Impact to the sternum (solar plexus)
The sternum is located in the center of the body. In this area is the heart, below the liver and stomach. There is no protection in the form of ribs. Therefore, a blow to this area directly affects the heart, diaphragm and nerves between the ribs. A blow to the solar plexus causes severe pain in the walls of the stomach and difficulty breathing. The enemy loses the ability to defend himself. A severe blow can lead to stomach bleeding, heart failure, liver rupture, internal bleeding, loss of consciousness and, in some cases, even death.
A blow between two ribs.
Usually the blows are directed to the 7th, 8th and 9th ribs and their connecting cartilages. On the left is the heart area, on the right is the liver. Ribs 5 through 8 are the most curved and the easiest to break, especially where the bones meet the cartilage. A strong blow to this area can cause a heart attack, liver damage, internal bleeding and possibly death.
A blow to the moving ribs.
Movable ribs are located at the bottom of the chest. These are the 11th and 12th ribs. They are not attached to the sternum. Since the ribs are not secured in front, the impact will cause them to break inward. This, in turn, can lead to their penetration into the liver or spleen, which is deadly.
A blow or pressure on the armpit.
Many blood vessels and nerves pass through this area. In addition, this cavity has no muscle or bone protection. Attacking this area with the fingers can cause an electric shock-type sensation and temporary loss of motor ability in the hand. Strong pressure can cause damage to nerves and blood vessels, making it difficult to move the arm.
A kick or hand to the pubic bone.
This area is very sensitive. A blow to it is quite painful and leads to the inability of the enemy to continue resistance.
Kick or hand to the crotch
Many nerves pass through this point, and above are the genitals and bladder. A slight blow to this area will cause very severe pain. A strong blow can rupture the bladder and cause shock.
A kick or hand to the tailbone.
In this area, the nerves are relatively protected and a strong blow can damage the central nervous system, causing severe pain and possible paralysis.
A blow to the kidneys
The kidneys are located very close to the posterior wall of the abdominal cavity. From an anatomical point of view, the kidneys do not have protection in the form of ribs and are very vulnerable. When struck, severe pain occurs, kidney rupture and profuse bleeding are possible.
A blow to the back area opposite the heart.
A blow to this point can cause shock, as there is a direct effect on the heart. This exposure can be fatal.
The most vulnerable points of the legs.
A blow to the kneecap.
A blow to this area causes severe pain. The greatest effectiveness occurs when the supporting limb on which the body weight is concentrated is attacked. The result of this impact will be damage to the tissue under the fibula and tibia.
A blow to the outside of the knee.
This impact will cause the joint to move in an unnatural direction, bending inward, and cause ligament damage as well as a tear between the bones of the joint. Additionally, a strong blow can damage the main peroneal nerve, causing severe pain.
A blow to the inside of the knee.
This impact will cause the leg to bend outward and damage the ligaments and tendons around the kneecap. The best angle to strike is a sharp downward angle towards the back
Among injuries to internal organs, a special place is occupied by brain injury, which can accompany skull fractures or be observed while maintaining the integrity of the cranial bones. Traumatic brain injury is often the cause of death of the victim.
Traumatic brain injury can be open or closed.
The most difficult to diagnose is a closed craniocerebral injury, which occurs from a blow to the head with a blunt object or as a result of a fall.
It is customary to distinguish the following main types of closed craniocerebral injury:
1) concussion;
2) brain contusion;
3) compression of the brain.
A concussion is characterized by molecular changes and is not accompanied by macroscopically pronounced changes. The decisive factor in a concussion is not anatomical, but functional disorders (in some cases, these disorders can lead to severe disorders, even death).
A brain contusion is usually combined with a concussion and is accompanied by local anatomical disorders in the brain matter in the form of one or more foci of destruction (crushing, hemorrhage). Destruction of brain matter can occur either directly at the site of impact or on the opposite side. The occurrence of direct or anti-impact (counter-impact) injuries is largely due to the mechanism of traumatic impact.
A blow to the head with a blunt object. When a head is struck at rest, the configuration of the bone changes: it bends inward, and then straightens due to elasticity. When the bone bends inward at the site of impact, positive pressure first arises, which changes to negative. In this case, gas bubbles are released from the tissues and blood, followed by their collapse, causing destruction of the brain matter (this phenomenon in physics is called cavitation). This is how a bruise occurs at the point of impact. Impact injuries to the brain from a blow to the head with a blunt object are, as a rule, absent or appear with a very high impact force and are insignificant.
Impact to the head while it is in motion (acceleration injury). A blow to a head moving at a certain speed occurs when falling or suddenly braking when colliding with an obstacle. In this case, a traumatic brain injury occurs due to acceleration of the “impact-counterimpact” type. According to the place where the force is applied, positive pressure arises in the cranial cavity, decreasing in the direction of the impact and turning into negative pressure due to the lag of the brain on the side opposite to the impact.
14. Issues resolved by forensic medical examination in cases of injury by blunt objects
When analyzing each specific case of harm to health, a forensic expert evaluates damage to soft tissues, bones and internal organs in their entirety, comparing them with each other and with damage to the victim’s clothing. Only with this approach can one of the main and most important issues be correctly resolved - the question of the mechanism of injury.
The degree of reliability of the expert’s conclusion increases even more if, in addition to assessing morphological data, the results of additional laboratory studies of trauma resulting from injury with blunt objects are used, which is especially important when deciding on the possibility of causing damage by an object or instrument presented for examination as material evidence.
Among the main issues that must be resolved during a forensic medical examination of injuries caused by blunt objects, the following can be identified:
1) what is the nature of the victim’s physical injuries (abrasions, bruises, wounds, dislocation, fracture, organ rupture, etc.);
2) what object caused the damage, in particular, whether this damage could have been caused by an object or instrument presented for examination as material evidence;
3) damage was caused by one or more objects;
4) how many blows were inflicted on the victim during the attack, in what direction or from which side they were inflicted;
5) if there was compression of the body or part of it, then from what side and in what direction did the compressive object act;
6) in what position (standing, sitting, lying) or in what position the victim was, and what was the relative position of the victim and the striker at the time of injury;
7) how long ago are the injuries on the victim’s body?
During the forensic medical examination of corpses, in addition to the main questions, a number of others are posed, which are common to all cases of traumatic death.
These are questions about the cause and duration of death; about signs indicating the victim’s struggle and defense; about the possibility of the victim taking any independent actions after receiving an injury; about whether the victim took food, when, what and in what quantity; the condition of the victim (whether he consumed alcohol, toxic or narcotic substances shortly before his death, and what was the degree of intoxication). A special place (especially during the examination of living persons) is occupied by the question of the severity of the injuries received (severe, moderate) provided for by criminal law.
15. Transport injury. Features of inspection of the scene of accidents in road traffic accidents
An independent group among mechanical damages consists of injuries caused by vehicles. There are road traffic injuries, injuries by water transport, and aviation injuries.
Road vehicles are divided into trackless (cars, motorcycles, trolleybuses, tractors, etc.) and rail vehicles (trains, trams, etc.).
The examination of the corpse must begin with an accurate recording of the location of the corpse in relation to the car, roadway, sidewalk, or in relation to various traces on the roadway. Inspection of clothing includes recording its condition, tears, drag marks, tread marks, car lining, radiator, headlights. Attention is drawn to soiled clothing, the presence and location of traces of blood, lubricating oils, glass fragments, car paint particles, and skid marks on the soles of shoes. There are tread marks on the body and the presence of fractures.
It is necessary to measure the level of these damages and marks (the distance from the soles to the damage). It should be taken into account that scraps of clothing, particles of epidermis, stains and splashes of blood, hair, fragments of internal organs, etc. may be found on parts of the car. All material evidence discovered during the inspection of the scene of the incident is sent for further examination to the appropriate laboratories.
Automotive injuries are injuries caused by the exterior or interior of a moving vehicle or by falling out of a vehicle. The variety of mechanisms at individual stages of a car injury leads to the formation of multiple injuries, different in nature and location. Some injuries are characteristic of certain types of auto injury (contact injuries). Damage that occurs when a moving vehicle collides with a person’s body (collision) is the most common. This type of auto injury includes several stages:
1) collision of car parts with a person. The mechanism of damage is impact and general shaking of the body;
2) a body falling onto a car. Mechanism - impact on a part of the car;
3) throwing and falling of the body onto the ground. The mechanism is impact on the ground. Localization – area of the head, torso, upper limbs;
4) body sliding along the ground. The mechanism is friction on the ground.
As a result of being hit by parts of the car, the body falling onto the car, or being thrown onto the ground, damage to the soft tissues of the head occurs, as well as fractures of the skull bones. There are direct, closed, linear and comminuted fractures, there are depressed and terrace-shaped, which depends on the place of application of the force, the direction of its action, the area of contact of the object with the skull.
Causes
The main cause of this type of injury is various accidents.
(plane crashes, road traffic accidents) that cause the head to hit heavy objects and hard surfaces. The most common causes are accidents involving cars, attempted suicide by jumping from a bridge into water, falling from a small height (from a ladder, stepladder, etc.). Sometimes the cause is a deliberate attack on a person or a fight, during which the person is hit in the face and head.
First aid for bruise:
- Lay the patient on his side, and place a rolled-up cushion under his head. This position is necessary in case of vomiting.
- A cold compress should be applied to the injury site. You can use frozen food from the refrigerator, or collect snow from the street in a plastic bag.
- Clear the oral and nasal cavities of vomit, dust and other foreign objects, if any;
- Perform artificial respiration if necessary.
- Stop bleeding from the nose, ears and abrasions, if any. It is necessary to avoid large blood losses, otherwise this may cause additional damage to the body.
- Before the ambulance arrives, under no circumstances should you give the victim drink, food or any medications.
In adults
The first signs of a concussion are clear. But, as practice shows, defining injury in this way is very problematic. Typically, diagnosis is based on a description of a citizen’s complaints. What can be observed some time after receiving a concussion?
There are many options for the development of events. In any case, with serious injuries, you will experience nausea and even vomiting. We are talking about repeated incidents. General weakness of the body, sleep disturbances (usually in the form of insomnia), pressure surges - all this also indicates a concussion.
Does your head hurt for a long time after hitting your head? Something like migraines has started? Is the temperature fluctuating? Does your face turn red for no reason? Then it's time to go to the doctor. You most likely have a concussion. It is noted that in adults, trauma is often manifested by memory loss (amnesia), sweating and tinnitus. It is possible that you will simply feel uncomfortable. Pay special attention to these signs.
