Trauma falls, the most afraid of hurting the head. Because the part is important, and sometimes it is easy to make a mistake if the judgment is not clear.
Not long ago, there was a news report that a primary school student fainted (loss of consciousness) because he was hit on the head, and then woke up, and the teacher did not care; after more than 2 hours, the small patient appeared dizzy, nausea, and vomiting; and then, after 4 hours, he fell into a coma again, and soon died. The reason is that head trauma caused intracranial hemorrhage and cerebral hernia.
It is also a pity to say that a case that has been experienced firsthand is also particularly regrettable.
It was more than thirty years ago. The roads in Beijing are not so good, the winter is cold, the snow is heavy, and there is no snow melting agent. After the snow, the snow melts when people walk on the car, and at night it freezes, and the road is like an ice sheet. If it snows again, or the wind blows snow particles onto the ice, it is particularly slippery and easy to fall down.
One afternoon, a parent of a student pushed a bicycle to pick up his child from school, and when he was not careful, he fell on the ice sheet and fell on his back facing the sky. A short time after the fall, he got up, moved, his arms and legs were fine, and when he picked up the child and came home, he came to the hospital to see.
At that time, there was no CT of the skull, only X-rays. No skull fractures were found in the film, and brain surgeons did not detect more abnormalities.
Although no injuries were found, because the patient fell to the back of the head, according to the medical "occipital", and there was a short loss of consciousness, the brain surgeon still left the patient behind and observed in the emergency observation room.
In the middle of the night, the nurse found that the patient was not right, and the pupil was large and small. This is a sign that the brain is compressed and there is a "brain hernia". Hurry up and report to the brain surgeon, hurry up the operation, but it is too late. It should be said that at that time, various technical conditions and drugs were not as good as now.
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When you fall on the head, you are comatose and faint for a while, which is called "loss of consciousness" in medicine; then you are awake for a period of time; you are aggravated again, you are unconscious again, and then you find various intracranial hemorrhages, cerebral edema, and cerebral hernias.
This process of coma-wake-wake-re-coma after brain trauma, the middle period of awakening, is the typical "intermediate awake period" after brain trauma.
When the brain is traumatic, the brain tissue as tender as tofu is hit and concussed in the skull, and it is injured, the light is the concussion; the heavy is the brain contusion and laceration. Injuries will react and consciousness will be lost. Therefore, if there is a loss of consciousness after a traumatic brain injury, it is at least a concussion.
When the head is just injured, if the brain tissue damage is not particularly serious, the injured brain tissue has not yet produced so much blood, there is not yet time for edema, the blood vessels in other parts of the skull have not yet produced so much blood, the brain has not been compressed, and the coma will be awake.
Sober is it okay? not necessarily! It may be that the "intermediate awakening period" of brain trauma is coming!
For patients who have lost consciousness after injury, we must not ignore this possible "intermediate waking period", and must go to the hospital for examination and observation in time.
Because the brain has been damaged, it may take a period of time for the injured brain tissue to bleed more, the edema to worsen, or other parts of the blood vessel damage bleeding more, it will increase the pressure in the skull, compressing the brain tissue, then there is a danger.
When intracranial pressure rises, the brain tissue is compressed, and the patient will have headaches, vomiting, or disturbances in limb movement, unclear consciousness, and coma again. If it is pressed into the life center, there is a possibility that the breathing and heartbeat will stop. Wait until then rescue, the effect is poor. Like the previous two cases, both failed.
However, sometimes because of this "intermediate awakening period" of brain trauma, people will mistakenly think that they are fine, and as a result, they will delay major events. Therefore, it is an "intermediate sobering period" that is easy to confuse people and misunderstand things, and we must remind everyone to pay attention to it.
Now that the examination methods are advanced, the ct of the skull can be found, but sometimes it is necessary to review it multiple times.
How is "loss of consciousness" judged? The simple way is to ask the patient, the injured person is clear and unclear, understand and do not understand. Sometimes although the patient feels dizzy, but the heart is clear, it is not considered loss of consciousness.
Now, in the north of winter, many places are already ice and snow worlds.
The Winter Olympics were held on the mainland, which also led to the ice and snow sports in the mainland, and more venues and projects for ice and snow sports were carried out.
Also, in an aging society, there are more elderly people. Of course, there is also the problem of accidents caused by developed traffic.
Everywhere, there is an increase in accidental falls and accidental injuries. Among them, the most dangerous and fatal is head trauma, and brain trauma with an "intermediate awake period" is easy to confuse people and requires us to be vigilant.
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