According to Professor Zhao Jizong's statistics, in 2002, about 1 180000 people died in various traffic accidents all over the world. Thousands of people were disabled by traffic accidents, and thousands of families suffered greatly. The number of people injured in traffic accidents in China has also increased rapidly, and more than half of them are craniocerebral injury, which has the highest mortality and disability rate. Among the patients with craniocerebral trauma admitted to Beijing Tiantan Hospital, traffic accidents caused the most injuries.
Due to the lack of self-help and self-care knowledge, many injured people get worse, leading to paraplegia, hemiplegia, vegetative state and even lifelong disability. Therefore, Professor Zhao Jizong reminds people that the brain is an extremely important organ of the human body, and lack of oxygen for 5 minutes will lead to brain death.
When a traffic accident happens, first call the first aid system such as 120 or 999, and the rescuer should record the injury time, the patient's position and posture. For conscious patients, patients can describe their illness and observe their whole body activities. For patients with neck and back pain, pay special attention to lying flat, and ensure that the head, neck and body are in a horizontal position when handling, so as not to cause spinal cord injury. If possible, we should put a neck brace on the injured person. Coma patients must lie on their backs, head back to one side, clean up the secretions in the patient's mouth in time to prevent respiratory tract obstruction caused by aspiration, and give oxygen. For patients with scalp laceration, simple hemostasis and dressing should be done, and at the same time, the blood pressure and pulse of the patients should be measured to observe whether the pupils of the injured patients are equal, so as to provide basis for further treatment of cranial neurologists.
People with head injuries must go to a nearby hospital with neurosurgical conditions. Medical staff should promptly and decisively deal with the condition and closely observe the changes of vital signs such as consciousness and pupils of patients. Neurosurgeons should give patients routine head ct examination to determine the brain injury, and immediately carry out corresponding treatment and nursing to ensure the recovery of brain function to the maximum extent. The more timely the treatment of craniocerebral injury, the better the prognosis of patients. While treating craniocerebral trauma, doctors should pay attention to the overall injury of patients and deal with it comprehensively.
Professor Zhao Jizong said that craniocerebral trauma can be divided into three types: mild, moderate and severe. What plays a decisive role in recovery is the degree of brain injury and the therapeutic effect. Those who are unconscious within 30 minutes after injury, have retrograde amnesia (short-term memory loss, long-term memory existence), dizziness and headache are regarded as "mild", and can be cured by proper use of analgesic drugs and bed rest 1 ~ 2 weeks. After the injury, he was in a coma for more than 30 minutes. Generally, the injured have cerebral hemorrhage, brain contusion and laceration, skull base fracture and so on. It belongs to "moderate" and the injured need hospitalization. Long-term coma, unequal pupils and urinary incontinence after injury, ct examination of intracranial hematoma greater than 30 ml is "severe" and requires surgical treatment to remove the hematoma.
Among the craniocerebral injuries caused by traffic accidents, brain stem injury is the most serious. The injured person may develop into a vegetative state, lose consciousness and be unable to communicate, but his heart function and respiratory function are still normal. Patients rely on long-term nasal feeding to maintain their lives, which brings great burden to families and society.
Post-traumatic brain injury syndrome (PTSD) refers to a group of autonomic nervous dysfunction or mental symptoms that exist for a long time after patients with traumatic brain injury recover. Include headache, nervousness, irritability, attention deficit, memory deficit, dizziness, insomnia, fatigue and other symptoms. There was no abnormality in nervous system examination and no positive findings in neuroradiology examination. If this group of symptoms does not improve for more than 3 months after brain injury, it is post-traumatic syndrome. Usually, most of these patients are mild to moderate closed craniocerebral trauma, and there is no serious nervous system injury.
Headache is the most common symptom, which can be severe pain, dull pain and pulsating pain, and can appear on the whole head, forehead or pillow. Occipital pain is usually accompanied by pain and tension in the muscles behind the neck. The time of headache attack is uncertain, but it can be aggravated by bad mood, fatigue and insomnia, so it is restless. A clear cause of post-traumatic headache is the loss of cerebrospinal fluid, which leads to intracranial hypotension and headache. Most patients with persistent or even severe cerebrospinal fluid leakage have no obvious headache symptoms, so the excessive production of cerebrospinal fluid can completely supplement the lost amount.
Dizziness has various manifestations, often complaining of dizziness, tinnitus and nausea, which is aggravated by body position change. Nervousness and irritability are also common, usually caused by stressful environmental factors. In addition, memory loss, difficulty in concentration, fatigue, mental retardation and insomnia may all be the result of psychological factors.
The manifestations of autonomic nerve dysfunction are palpitation, blood pressure fluctuation, hyperhidrosis, menstrual disorder and sexual dysfunction.
According to the literature, the symptoms after brain trauma are sometimes related to the injured site. There are fewer symptoms after forehead injury; More than half of them have dizziness and memory disorder after temporal injury; However, difficulty in concentration, nervousness and fatigue are more common in patients with top trauma.