Up to 10 years, any strong impact can cause injury. Bumps, falls, jumps, and even sudden braking risk ending in shaken baby syndrome and concussion.

In young children, mild symptoms are less noticeable, and a serious injury is more likely to lead to behavioral problems, emotional and physical consequences in older years.

As you get older by the age of 10, the signs of malaise are more and more similar to a concussion in an adult.

How to determine that there is a problem?

The first symptoms of a concussion in a 3-year-old child appear immediately or after a couple of hours (sometimes days). Loss of coordination, nausea and vomiting, headache, dizziness, altered pulse - a characteristic condition.

Important! Children don't always faint. Already 2-3 signs of malaise testify to the injury.

Signs of a concussion in a child under 3 years old

Children are mobile, curious, not afraid of heights, they have fragile bones and a developing skull. Although the fluid in the brain tissue can cushion the blow, it is often the head that is injured. It is heavier than other parts of the body, and the child does not have time to substitute his hands when falling. Preschoolers account for 20% of pediatric concussion cases.

At 3-4 years old

• Consciousness "extinguishes" for a few seconds and the child cannot explain how he got injured.
• He staggers, coordination of movements is disturbed.
• Sensitivity and reaction to stimuli is reduced due to oxygen deficiency in brain cells.
• There are complaints of headache, tinnitus, dizziness.
• The skin becomes pale or whitish.
• Circulatory failure provokes nausea or characteristic repeated vomiting.
• The baby is covered in cold sweat.
• Breathing quickens, tears and saliva flow.
• The pulse is rare.
• Complaints of pain in the navel, pressure in the left hypochondrium.
• The child loses his appetite, sleeps poorly, is naughty.

Symptoms in children 5 to 6 years of age

The manifestation of the disease in girls and boys of school age

By the age of 7-8, the formation of the skull ends, the bones become stronger, the growth of the head slows down, and the brain is less susceptible to external influences. The first signs of injury in children 7-8 years old often appear after a couple of hours. The physical and emotional consequences of concussion lead to the fact that the student finds it difficult to concentrate, academic performance drops, apathy, irritability and aggressiveness appear. If a child refuses favorite activities and sleeps a lot, this indicates hidden problems.

For first graders aged 6-7

• Fainting, short-term memory loss (up to 15 minutes).
• Possible "post-traumatic blindness" and hearing loss.
• Loss of orientation.
• Tachycardia.
• Nausea or vomiting.
• Red circles before the eyes.
• Weakness and trembling of the limbs.
• Cold sweat.
• Pallor.
• Insomnia.

For students in grades 2-4

Symptoms of a concussion in children under 10 years of age are as follows:

• Fainting can last from a few seconds to 10-15 minutes.
• The small arteries of the face now narrow, then expand, and the pallor of the skin is replaced by redness.
• Vision is impaired: gaze paralysis, chaotic movements of the eyeballs, short-term strabismus, changes in the width of the pupils, double vision.
• The schoolboy complains of a strong headache, sometimes he cannot hold back his tears.
• There is a gag reflex and nausea.
• Breathing is uneven.
• Bleeding from the nose or ears.
• Coordination and memory are impaired (unable to tell what happened before the injury).
• The pulse quickens (more than 90 beats) or falls (less than 60).

Important! Visual impairment (post-traumatic blindness) in all ages lasts from a few minutes to a couple of hours after the impact. It passes without visible consequences.

Manifestations according to severity

Signs in babies under 5

Injuries to the developing skull have a greater impact on future health, but children younger age almost do not lose consciousness - this is more common for older students.

Symptoms in children 6-10 years old

It can often be delayed symptoms appear hours or days after the stroke.

1. For mild concussion- no loss of consciousness. Mild malaise (nausea, headache, dizziness). It passes, as in young children, in 15-20 minutes without visible consequences.
2. In case of injury moderate - the schoolboy complains of visual impairment, "flies" before his eyes and tinnitus, vomiting. After an injury, it is difficult for him to maintain balance, he “turns off” for 1-2 minutes or loses concentration. To identify the problem, it is enough to ask him simple questions.
3. heavy- this is loss of consciousness, impaired thinking and speech, severe headache, frequent vomiting, perspiration. The injury disrupts the sequential chain of events in the memory, and he cannot say how he received the concussion. In rare cases, the child has other memories.

Schoolchildren often do not admit that they have been injured. The appearance of several symptoms is a reason to immediately consult a specialist.

First aid

Regardless of the severity of the injury you need to quickly deliver the victim to the traumatology on your own or call an ambulance. We need to ensure the flow fresh air and peace. The child is laid on its side so that it does not choke on the vomit. With a strong thirst, the lips are moistened with water, but drinking is not recommended. Changes in the pulse are monitored along the carotid artery. Cold is applied to the cone. If there is a wound, then a clean gauze or cloth napkin is applied to its surface.

The child is forbidden to sleep: in the waking state, the dynamics of the state is better visible.

If the child is unconscious, he is laid on his right side, his right bent arm is placed under his head, and his legs are bent at the knees. This position will also prevent you from choking on vomit.

Treatment

In moderate and severe cases, inpatient treatment is prescribed. In mild cases, the child is treated on an outpatient basis.

In the hospital

In the hospital, hardware examinations are carried out, which will reveal the degree of damage. The victim is provided with complete rest, bed rest and drug treatment. The choice of medicines is aimed at

A concussion is one of the most common childhood injuries that occurs as a result of their excessive activity. Babies are in such a hurry to explore the world that sometimes even the most attentive moms and dads can't keep up with them.

If we consider childhood injuries in general, then concussion occupies a leading place among them. Outwardly, it is not easy to determine it, because it has no special signs (bumps, bruises and swelling do not count). Given that a concussion is still a trauma, the child who received it requires immediate hospitalization. That is why adults should be able to recognize a concussion in their baby and know which doctor to take him to.

Concussions are an injury that requires medical treatment, so parents should be able to recognize its symptoms.

Causes of a concussion

45% of children with traumatic brain injury (TBI) are schoolchildren, 25% are infants, 20% are preschoolers, 8% are toddlers and 2% are newborns. Causes of trauma to the skull depend on which age group baby applies. Parents should be aware of the likely risks to avoid dangerous situations. Consider in more detail the causes of concussion in children:

• Excessive parental carelessness and inattention are the main reasons why babies can get a concussion. If babies fall from sofas, changing tables, hands of parents, fall out of cribs and strollers, then as a result of such “flights” brain injury occurs. When parents need to leave, a small child must be left in an arena or a bed with sides from where he cannot fall.
• Some babies already know how to walk at 1 year old, while others are just learning this art. At this age, the main cause of TBI is frequent falls on the floor. The height of such falls is equal to the height of the baby.
• As children grow older, they strive to learn as much as possible about the world around them. To do this, they "conquer the peaks" in the truest sense of the word. They already know how to climb ladders, fences, windows, roofs, trees, slides, etc. That is, the height of the fall becomes greater, and the possible injury becomes more serious.
• Preschoolers can injure their heads by suddenly accelerating or stopping abruptly. In science, this condition is called "shaken baby syndrome." The cause of a concussion can also be the violent treatment of a baby, strong spinning on a swing, reckless jumping from a great height, riding a bicycle without a helmet.

• Children are most often admitted to emergency rooms with concussions. school age. This trend is due to the fact that schoolchildren are constantly in contact with each other, and at the slightest divergence of views, the problem is solved with the help of fists. In addition, they can be injured while running, jumping, active physical education and sports.

Three grades of concussion severity

In medicine, there are three degrees of severity of brain injury:

• light;
• average;
• heavy.

The first degree of concussion is characterized by the complete absence of any symptoms. If they do appear, they will have a mild form and will pass on their own within the next 30 minutes. It can be either mild dizziness or a mild headache without loss of consciousness. This degree of brain injury to the head is considered the easiest, so therapy is not needed in most cases. Despite this, the child should not be left without an examination by a qualified doctor.

A concussion of the second degree is expressed by minor bruises of the brain and slight damage to the bones of the cranial vault. A child who has received a similar injury may feel sick and dizzy. It can be nauseating and sometimes even vomit. The kid is disoriented in space. All these symptoms do not pass through time, as in the first degree, the child is constantly conscious. In this case, a doctor's examination is required.

With a bruise of the brain and damage to the bones of the cranial vault, the child will have pain and dizziness

A concussion of the third degree is a serious brain injury, which is characterized by hematomas that compress the brain and fractures of the bones of the base of the skull. All this is very dangerous and threatens to fall into a coma. In addition, a severe brain injury often causes malfunctions in the work of all systems of the child's body. This degree of TBI is characterized by the following manifestations:

• fainting lasting more than 15 minutes;
• impaired speech, hearing and vision;
• amnesia;
• weak and rare breathing;
• pupil dilation;
• swallowing dysfunction;
• hypertension;
• increased heart rate;
• temperature rise;
• possible bleeding from the ear.

Symptoms in children different ages

If we compare a concussion in an adult and a child, we can see that the same injury manifests itself in different ways. This difference is due to the peculiarities of the structure of the brain in children.

In addition, trauma in children of different ages makes itself felt in different ways too. The older the child, the easier it is to understand that he has a concussion.

Signs of a concussion in a newborn and baby

The main symptoms that indicate that a newborn or infant has a concussion:

• loss of consciousness;
• refusal to eat;
• frequent regurgitation after feeding;
• increased body temperature;
• vomit;
• lethargy and drowsiness or, conversely, overexcitation and anxiety;
• sleep disturbance;
• twitching of the muscles in the limbs;
• pallor of the face or covering it with red spots.

Any of the signs may appear only the day after the injury. In addition, the child may begin to cry some time after the bruise. This picture is explained by a short-term loss of consciousness, which lasts a fraction of a second, because of which it goes unnoticed.

The area of ​​the head in the baby is most prone to bruises

It is worth remembering that even a slight head injury is a good reason to take the child to the doctor.

Symptoms in children aged 1 to 3 years

During this period, not all children can talk, which means they will not be able to talk about their feelings. Despite this, attentive parents can immediately notice the uncharacteristic behavior of the child. The main signs that a child who is not yet 3 years old have a concussion are as follows:

• dizziness;
• nausea;
• frequent vomiting;
• discoloration of the skin of the face;
• unstable pulse and blood pressure;
• disorientation in space;
• refusal to eat;
• pain in the navel;
• temperature rise;
• bad sleep;
• capriciousness.

The symptoms of a concussion in young children are many and do not appear immediately; so, the child may refuse to eat, act up and complain of headaches

TBI can manifest itself through one symptom or a whole complex of them. To do this, parents need to watch the child for a certain time.

Signs of a concussion in older age

It is much easier to identify TBI in a child who is already 4, 5 or more years old than in a one-year-old or newborn, since he himself is already able to tell what and where it hurts. Head injuries at this age are manifested as follows:

• temporary loss of consciousness;
• partial memory loss (the baby does not remember what happened before the head injury);
• headaches and dizziness;
• the appearance of a gag reflex;
• constant nausea;
• pallor;
• delayed reaction of the baby to the people around him;
• severe weakness in the body;
• hypotension;
• palpitations.

First aid while waiting for the doctor

Hitting a child's head, even the smallest one, can cause serious health problems.

Before the doctor arrives, the baby should be given first aid by performing the following actions:

1. if the baby is unconscious, he should be placed on his right side, while bending his left arm and leg at a right angle (this position of the body will ensure proper breathing);
2. check heartbeat and breathing;
3. measure the pulse;
4. in case of a threat to life, take resuscitation measures;
5. examine the victim in order to identify bruises or fractures;
6. in the presence of Chlorhexidine, treat wounds with a solution;
7. apply a wet cold towel or ice to the site of injury;
8. find out the details of what happened from eyewitnesses;
9. if the baby is conscious, he needs to ensure a horizontal position of the body, cover with a warm blanket, ask the baby about what and where it hurts.

Before the arrival of the doctor, it is necessary to put the child on the bed, treat the wounds with Chlorhexidine and apply a cold wet towel or ice to the head

Care must be taken to ensure that the baby does not fall asleep before the arrival of the doctor, as sleep can aggravate his condition. Active games, like painkillers, are contraindicated for the patient so far. The latter should be prescribed by the doctor after examining the baby.

TBI diagnostics

In order to diagnose a concussion in a child, the doctor prescribes:

• examination by a pediatrician and neurologist;
• general analysis of blood and urine;
• examination by an ophthalmologist of the fundus;
• CT or MRI of the brain (methods make it possible to exclude concussion of the third degree of severity);
• x-ray (to exclude the presence of fractures of the skull bones);
• Ultrasound (to assess the state of the brain);
• neurosonography (assigned to babies from 0 to 2 years old to detect edema, hemorrhages, hematomas);
• echoencephalography (used in older children to detect possible displacements indicating the presence of tumors and hematomas);
• electroencephalography (study of brain activity);
• lumbar puncture (cerebral fluid sampling).

An MRI of the child's brain is necessary to confirm or rule out a third-degree concussion

Of all the above procedures, encephalography and lumbar puncture are optional. They are not used in all cases.

Child treatment

After making a diagnosis, the doctor decides what to do with the baby next: hospitalize him or allow treatment at home. As a rule, children under 6 years old are treated permanently. This is due to the fact that there is a risk of developing complications such as edema, hematomas, convulsions. If this happens at home, the parents will not be able to provide the child with the necessary assistance.

Therapy in the hospital using medications

In a hospital setting, a baby who has received a concussion is given medication using the following groups of drugs:

• diuretics;
• painkillers;
• nootropic;
• sedatives;
• antiallergic;
• potassium-containing;
• from bouts of nausea;
• vitamins.

1. Diuretic drugs help to avoid cerebral edema. These include Furosemide and Diacarb.
2. In parallel with the drugs of this group, potassium-containing drugs are prescribed - Panangin, Asparkam.
3. Nootropic drugs - Piracetam, Cavinton - activate the supply of nutrients to the brain, and also help improve blood circulation in it.
4. Valerian infusion or Phenozepam is usually used as a sedative.
5. To alleviate the condition of the child and eliminate his pain analgesics such as Baralgin or Sedalgin are used.
6. To get rid of bouts of nausea, Cerucal is used.
7. Vitamins and antiallergic drugs - Fenistil, Diazolin, Suprastin - are prescribed for a speedy recovery.

Treatment at home

If the treatment in the hospital brought positive results, and the child began to feel better, he can be discharged home, but on the condition that the parents follow the following recommendations:

• the baby should not watch TV and play computer games;
• bright and sunlight should not affect the patient;
• the child is obliged to move as little as possible;
• bed rest is required after discharge from the hospital for at least 7 days;
• it is necessary to exclude situations that provoke hysteria in a child;
• it is important to strictly observe the intake of medications.

Complications after a concussion

The consequences of TBI can appear unexpectedly and with numerous complications. No one can answer the question of how long to wait.

They can occur after 1, 2 or 12 months, or even after 10 years. It all depends on the severity of the injury and on the individual characteristics of the child's body. The most common complications of TBI are:

• irritability;
• excessive emotionality;
• fatigue;
• tendency to depressive states;
• dependence on the weather;
• sleep disturbance;
• the emergence of fears;
• increased susceptibility to infections;
• epileptic seizures;
• headaches and dizziness;
• hallucinations;
• memory and speech disorders.

Consequences can be avoided if the victim is provided with timely medical assistance and prescribe the correct treatment. If at least one of the above symptoms nevertheless began to appear, it is necessary to show the baby to the doctor.

Children's increased activity, curiosity and restlessness, combined with imperfect coordination and a reduced sense of danger, explain the frequency of child injury. Moreover, young children have not yet acquired the skill of belaying their heads with their hands, so the consequence of bumps and falls in children is often a concussion (CCM).

CGM is the most common type (90%) of traumatic brain injury (TBI) in children. 120 thousand children in Russia are annually hospitalized with a concussion in a hospital.

Among all TBIs, concussion belongs to mild forms, but even this injury can lead to complications.

The reasons

Children often fall and in doing so can get a head injury.

The frequency of TBI and the reasons for their receipt are specific for each childhood. Thus, newborns account for 2% of all cases of childhood TBI, infants - 25%, toddlers - 8%, children preschool age- 20%, schoolchildren - 45%.

It is clear that babies and infants get TBI due to an oversight or carelessness of their parents, falling from the changing table, from the stroller, and even from the hands of their parents. After a year, starting to walk, the baby can be injured when falling from a height of his height, and a little later - falling from a hill, ladder, swing, from a window, from a tree, etc.

At the same time, the fact of injury is not always known to parents if the child was left under the care of relatives, nannies, older children, children's workers. preschool institutions. Older children themselves may conceal the fact of a fall for any reason.

It should also be remembered that brain injury can occur without a direct blow to the head. This is the so-called shaken baby syndrome.

CGM can occur with sudden braking or acceleration of the body when running, when jumping from a height with landing on the feet, and even with intense motion sickness of the baby.

Signs of a concussion

Symptoms of CGM in children differ from those in adults (loss of consciousness, nausea, dizziness, headache, vomiting, memory loss, etc.). The child's brain has distinctive features. For this reason, children rarely have the classic signs of CGM that are inherent in adults.

The smaller the child, the less obvious symptoms of a concussion. In babies, loss of consciousness occurs only in rare cases.

Typical for CGM for young children will be:

• anxiety;
• causeless crying;
• regurgitation (or repeated vomiting);
• loss of appetite;
• pallor skin;
• bulging fontanel in infants;
• sleep disturbance (drowsiness or poor sleep).

For school-age children, the clinical symptoms of SGM are as follows:

• loss of consciousness is noted more often;
• in some cases, amnesia is possible (loss of memory for the circumstances of the injury);
• nausea;
• vomiting (may be repeated);
• headache (in varying degrees of severity);
• slow or rapid heart rate;
• instability of blood pressure;
• severe pallor;
• sweating;
• disturbed sleep (insomnia or drowsiness);
• irritability or apathy;
• tearfulness and whims.

Sometimes after an injury or a little later, post-traumatic blindness occurs in children, lasting from several minutes to several hours, then disappearing on its own. More often, such a symptom manifests itself after a blow to the occipital region of the head, where the visual center is located.

One of the features of the symptoms of SGM in a child is that they may not occur immediately, but after some time (from several hours to several days). In this case, the symptoms can grow very quickly.

When a child is injured, it is difficult to determine whether brain damage has occurred. Even imaginary well-being for a long time does not exclude the presence of an internal hematoma, which manifests itself as a progressive worsening of the condition in the future.

Given these features of the clinical manifestations of TBI in children, it is necessary to consult a doctor at the slightest suspicion of injury, even with mild symptoms, without complicating the situation.

The danger with SGM is not in painful sensations from bruising of the soft tissues of the head, and in possible deep lesions nervous system. The internal hematoma (hemorrhage) that has arisen in the brain tissue is more dangerous than in an adult.

Children in such cases are examined by a pediatric traumatologist (or neurosurgeon), a pediatric neurologist.

If necessary, doctors prescribe additional methods of examination:

• neurosonography (ultrasound of the brain) - for small children (up to 2 years old);
• echoencephalography (after 2 years);
• CT scan of the brain;
• lumbar puncture;
• electroencephalography.

To identify hidden fractures of the skull, an x-ray of the skull is prescribed.

Here is what experts say about concussion in children and first aid for injuries:

Head injury in a child: what to do? Advice to parents - Union of Pediatricians of Russia.

Summary for parents

With a head injury in a child, one should not try to make a diagnosis on their own, exclude a concussion. Moreover, one should not hope that a child who has been injured will “lie down and everything will pass”. It is better to consult with specialists without delay. With timely diagnosis and treatment, concussion has a favorable outcome.

Which doctor to contact

If a child’s head is injured or bruised, it is necessary to show it to a neurologist, especially if his condition has changed and complaints have appeared. If this is not possible, you need to contact the pediatrician observing the child. Additionally, a consultation with a traumatologist, as well as a neurosurgeon, is often required.

Children are unable to sit still - they climb into hard-to-reach places, climb hills, and therefore are prone to injury. Even the most attentive parents may not notice how the baby hits his head. Traumatic brain injury is a condition that requires immediate hospitalization, because a concussion in a child - not every adult will determine the symptoms and signs. If the pathology is not noticed in time, the baby will have serious health problems later.

What is a concussion

A reversible brain injury caused by an injury is called a concussion. Doctors believe that this condition is based on a functional disruption of communication between nerve cells. In terms of frequency of occurrence, concussion ranks first among all head injuries. In the structure of childhood traumatism, 65% of all cases are assigned to this condition. According to statistics, closed craniocerebral injuries are more often observed at the age of up to 5 years and after 14.

How to identify a concussion in a child

After a head injury, it is important to provide the baby with timely medical care. Symptoms of a concussion in children manifest themselves in different ways, depending on the severity of the disease: mild, moderate, severe. Nature made sure that the children's brain was protected from damage, therefore, when in contact with heavy objects, the bones of the skull are cushioned, as they are mobile and strong.

Due to this, most injuries do not have negative consequences, especially in one-year-old children, whose body weight does not create strong inertia. However, with a significant impact, a child of any age can earn a traumatic brain injury (TBI). The smaller the baby, the more difficult it is to identify his disease, because children react differently to irritating factors. Parents should be careful and have information: if a child has a concussion, what are the symptoms?

Symptoms

Regardless of age, body temperature does not change with TBI. Symptoms of a concussion in a newborn child are insignificant: sleep disturbance, profuse regurgitation that lasts no more than 3 days. In older children, after a blow, the following conditions can immediately appear:

• pallor of the skin is abruptly replaced by reddening of the face (erythema);
• repeated or single vomiting;
• temporary desynchronization of the movement of the pupils (astigmatism);
• there is no consciousness;
• fast or slow heart rate;
• nose bleed;
• erratic breathing;
• lack of pupillary response to stimuli.

Headache

With timely and proper treatment of a concussion, all the symptoms that arise in this case pass quickly, but the headache can remain for a long time. The problem with young children is that they cannot tell what hurts them, so even if there are no obvious symptoms, you should see a doctor. Adolescents may be silent about the trauma, fearing parental anger, but if they have a headache that does not go away within 1-2 days, and is accompanied by dizziness, this fact should alert.

signs

Any pediatrician knows how a concussion manifests in a child - often they are not detected immediately after the impact. Sometimes TBI can be earned for no reason, when the baby starts abruptly or slows down. In medicine, this term is called "shaken baby syndrome." The causes of concussion are fights, falls from bicycles and other vehicles, jumping from a height. Excessive activity often ends in a head injury. In infants, the disease often occurs due to an oversight of the parents. Consider the most important signs of a concussion in a child.

Pupils in concussion in a child

A direct confirmation of a concussion is the size of the pupils. They can be like different shapes, and expanded or narrowed. The pupils react normally to light, and the affected child may not even feel any symptoms, but the doctor will notice the wrong reaction. Worse if they different size- this indicates a severe brain injury. Dilated or constricted pupils are associated with intracranial pressure, which affects the nerve centers that regulate the contraction of the eyeball.

If a concussion in a small child has symptoms of nausea and vomiting, then ice should be applied to the site of the bruise and called ambulance or take him to the hospital. The baby can vomit the contents of the stomach through the mouth once or repeatedly with some interruptions. At the same time, tears, saliva are released, breathing quickens. The cause is impaired blood circulation in the vestibular apparatus and the vomiting center, which is irritated upon impact.

Signs in the chest

A newborn baby cannot complain about health, therefore, the sooner a concussion is diagnosed, the sooner hemorrhage can be avoided. Signs of concussion in infants are primary and secondary. With a slight bruise, the child has motor activity, he is excited and screams. Secondary signs, when the baby refuses to eat, becomes lethargic and inactive, indicate a severe injury. The doctor will make the diagnosis of "brain concussion" on the basis of even one of the above factors:

• vomiting that has happened more than 2 times;
• short-term or long-term loss of consciousness;
• anxiety, poor sleep.

Dangerous signs that may indicate a serious traumatic brain injury in infants:

• a sharp decrease in the reflexes of the newborn;
• oculomotor disorders;
• bulging or swelling of the fontanel area;
• constant sleep;
• refusal to eat.

The first signs of a concussion in a child

If the brain is damaged, a child of any age immediately loses orientation in space, his ability to concentrate his eyes is turned off. At such moments, the eyes move involuntarily. The patient becomes lethargic, wants to sleep constantly, regardless of the time of day. With TBI, children usually experience headache, dizziness, nausea, and vomiting. Common signs of a head injury are excessive sweating, weakness, increased blood pressure, and rapid pulse.

Changes in the skin

Parents should be alerted by the pallor of the skin, the lack of elasticity. This is one of the most important symptoms that manifests itself immediately. First, the epidermis turns pale on the face, then on the limbs. The skin may become greenish or blue tint to appear transparent. Capillaries are clearly visible on the legs and arms. Often, pallor is accompanied by increased sweating - this is a particularly alarming signal that the baby's condition is deteriorating.

How to Diagnose a Concussion in a Child

It is necessary to immediately identify the presence of bumps, hematomas, fractures, to detect signs of cerebral edema in order to avoid serious consequences. This requires different diagnostic methods. The order of the standard examination of a sick child, which is used in a hospital:

• consultation of a traumatologist and a neuropathologist;
• the doctor determines intracranial pressure with an ophthalmoscope;
• brain radiography and computed tomography are prescribed;
• after examination and history taking, the specialist performs echo-encephalography, neurosonography, electroencephalography or MRI.

Depending on the severity of brain damage after diagnosis, the issue of hospitalization of the baby is decided. If serious injuries were not revealed, then the duration of stay in the hospital is 4 days. In case of a severe bruise, the minimum stay of the child in the hospital is one week. The consequences of a concussion are treated only with medication. The child is assigned:

• diuretics: Diakarb, Furosemide;
• potassium-containing drugs: Asparkam, Panangin;
• sedatives: Phenazepam, valerian tincture;
• antihistamines: Diazolin, Suprastin;
• painkillers: Baralgin, Sedalgin.

After leaving the hospital, the baby should receive additional treatment at home. This is taking nootropic drugs and vitamins prescribed by a doctor. A prerequisite is bed rest for 14 days after discharge from the hospital. The child should not be overstressed. You will have to change your usual lifestyle during rehabilitation - reduce the amount of time you watch TV and limit the amount of time you spend on the Internet. If the symptoms return, then you need to contact the doctor again. Headaches, drowsiness and malaise should not be felt after the course of treatment.

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A concussion is a serious traumatic brain injury. It is possible to determine changes in the pathological and morphological type not only at the subcellular, but also at the cellular level. Signs of a concussion in a child may be subtle or pronounced, depending on the degree of damage. Treatment should not be carried out without consulting an experienced doctor.

Causes of concussion

In infants, a concussion occurs due to the fact that parents and loved ones do not provide proper care, or, by pure chance, do not have time to prevent a fall. Even careless motion sickness can cause the development of disorders.

After one year old the child begins to walk and can cause injuries in the process of walking, which will cause serious complications in the absence of modern treatment. A little later, craniocerebral injuries occur when falling from swings, slides and stairs. There are cases of falling from windows, trees, etc.

Brain injury can occur in the following cases:

• abrupt stop or acceleration;
• falling or jumping from a height;
• strong untwisting and shaking;
• ball hit or collision.

The incidence of brain injuries in children has specific features:

• 2% of cases are newborns;
• 8% of cases - from 4 to 6 years;
• 25% of cases - from 1 to 3 years;
• 45% of cases - from 7 years and older.

Not in all cases, the fact of the fall is known to parents, since caregivers, teachers and relatives may hide the incident. Children themselves can hide what happened, so it is not always possible to immediately determine the presence of a traumatic brain injury.

Diagnostic equipment comes to the rescue, with the help of which even a damaged area of ​​\u200b\u200bthe brain can be detected.

Classification of concussion

There are 3 degrees of concussion in childhood, which have different severity and are accompanied by certain symptoms.

1. Mild - characterized by a complete absence of symptoms. Signs can be expressed very poorly. After 25-30 minutes, brain functions are restored on their own. TBI can be recognized by the presence of mild dizziness and headache. The child remains conscious.
2. Medium - accompanied by minor damage to bone structures and moderate brain injury. Possible dizziness and headache. As a rule, nausea appears, which is accompanied by vomiting. Quite often, disorientation occurs when the child cannot remember what happened.
3. Severe - we are talking about serious damage and impaired function. In this case, there are hematomas that compress the brain. Fractures of the base of the skull are not excluded. This condition is very dangerous and can cause the child to fall into a coma.

To determine the degree of brain damage, it is imperative to immediately go to the clinic. Only a doctor can make a correct conclusion and prescribe an effective medical correction in a timely manner. Treatment helps manage symptoms and prevent complications.

Signs of a concussion in a child

In mild to moderate TBI, symptoms are limited. There is a slight headache and mild dizziness. Nausea is not always accompanied by vomiting. In severe TBI, there is a short-term fainting or loss of consciousness for more than 15 minutes. The child may lose sight, hearing, or speech. Amnesia is not ruled out.

In childhood, the main manifestations of brain injury are the following symptoms:

• thinning and weakening of breathing;
• dilated pupils and violation of swallowing functions;
• lack of pupillary response to light, increased heart rate and hypertension;
• increased body temperature and bleeding from the auricle.

Signs of a concussion may be present in a complex or occur gradually or alternately. The nature of the manifestations of injury depends on the degree of damage.

Baby symptoms

Symptoms of a concussion in a child early age are different. This is due to the fact that babies have a different anatomical structure. The older the children get, the easier it is to understand their condition.

In infants, TBI manifests itself as follows:

• short-term loss of consciousness after injury;
• loss of appetite, insomnia, hyperactivity or lethargy;
• frequent vomiting or spitting up after each meal;
• pallor of the skin or the appearance of red spots;
• periodic unnatural muscle twitching.

Symptoms may appear immediately or after a certain period of time - from several hours to several days. This is due to loss of consciousness, lasting for several seconds, which most often goes unnoticed.

Symptoms in older children

From the first to the third year of life, the symptoms of a concussion in children are the occurrence of frequent vomiting and the appearance of pain in the navel. The child may become very moody and refuse to eat. It is not excluded an increase in body temperature and a change in the color of the skin on the face, which occurs against the background of changes in the process of blood circulation.

From the age of 4-5, it is much easier to determine a TBI, because children can pinpoint exactly where it hurts and talk about how they feel. The child may not remember what happened before the injury, feel nausea and dizziness. There is a slow reaction to others, weakness in the body and a disturbed heartbeat.

First aid

When a child has a concussion, symptoms and treatment are closely related. You need to focus on his condition. After a fall or injury, it is imperative to call an ambulance. Complications may not appear immediately, but even after a few days. Parents may already decide that everything worked out, and after a while the child will begin to complain of new symptoms.

Prior to the arrival of a team of specialists, the following measures must be taken.

1. If the baby is unconscious, it must be laid on a hard surface, turning on its side. The position of the body was stable.
2. When fainting, it is important to ensure that the tongue does not close the nasopharynx, preventing the flow of air.
3. In the presence of a slow pulse or uneven breathing, it is necessary to do a heart massage, coupled with artificial respiration.
4. If there are bleeding wounds, treat them to prevent blood loss and infection.

An important condition is to ensure complete rest until the doctor arrives. It is mandatory to ask the child questions about his well-being and pass the information to the doctor.

Ice or a towel soaked in cold water can be applied to the bruise, which will prevent swelling and bruising. Please note that the victim needs rest, but not sleep. You need to talk with the child, calming and encouraging him.

Diagnostics

A complete examination is carried out in a clinic. You need to contact a pediatrician, an ophthalmologist, a neurologist and, without fail, a traumatologist. Specialists will be able to determine the deviations that have arisen and prescribe timely effective treatment.

For appointment effective treatment a comprehensive diagnosis is required.

1. NSG (neurosonography) - provides for a visual examination of the parts of the brain through ultrasound scanning. This technique is recommended for children until the fontanel closes.
2. EEG (electroencephalography) - the procedure is carried out to obtain graphic data in order to determine the electrical activity of cellular structures in the brain area. Small electrodes are attached to the surface of the head, fixing the indicators. In infants, the procedure is performed during daytime sleep, which makes it possible to assess the severity of the injury, identify the tumor and establish the lesion of the central nervous system.
3. Radiography - makes it possible to assess the thickness of the bones and the structure of the skull, fontanel and cranial sutures.
4. MRI (magnetic resonance imaging) - is prescribed to detect concussion and the degree of damage to the central nervous system. The diagnostic procedure makes it possible to identify hemorrhage and developmental pathologies.

Treatment

The tactics of treatment will depend on the results obtained after a comprehensive examination. In the hospital, parents will be offered inpatient observation for 2-3 days, which will eliminate the likelihood of complications after a bruise. It is important to limit the child's physical activity, even if he will be in excellent health. Avoid watching TV and playing computer games.

If necessary, the doctor prescribes drug therapy.

1. Diuretic drugs (Furosemide, Diakarb) - to eliminate or eliminate the likelihood of cerebral edema.
2. Potassium-based medicines (Panangin, Asparkam) - are prescribed when using diuretic drugs in order to normalize the level of magnesium and potassium in the body, regulate metabolic processes and expand the coronary arteries.
3. Drugs to improve blood circulation (Piracetam, Cavinton) - nootropics contribute to the active nutrition of brain cells. restoring its functions.
4. Sedative drugs (Phenazepam, Novo-Passit) - to improve overall well-being.
5. Allergy remedies (Fenkarol, Suprastin) - have a positive effect on the permeability of vascular structures.
6. Painkillers (Baralgin, Analgin) - designed to reduce discomfort, facilitate the functioning of the brain, increase muscle tone and improve the processes responsible for conducting nerve impulses.
7. Nausea medicines (Cerucal) - help to cope with nausea and prevent vomiting.

The dosage is calculated by the attending physician individually, taking into account the patient's age, body weight and the degree of disturbances that have occurred in the body. Of great importance is the presence / absence of concomitant diseases.

Forecast and prevention

After an injury, serious complications develop only if treatment is not carried out on time or is completely absent.

1. Postconcussion syndrome. It manifests itself in the form of headache, dizziness, impaired memory and concentration.
2. Asthenic syndrome. Disorders that are characterized by weakness, decreased mood, irascibility and nervousness. It is manifested by daytime sleepiness, a decrease in working capacity and the development of memory problems, a decrease in the temperature of the extremities.
3. Vegetative-vascular dystonia. Polyetiological syndrome indicating dysfunction of cardio-vascular system and hearts. It can provoke the development of phobias, panic disorders.
4. Post-traumatic epilepsy. It is characterized by the presence of epileptic seizures, which have a convulsive character. In 80% of cases, it occurs within 2 years after CMS. There are accompanying intellectual-mnestic and emotional disorders.

Measures to prevent concussion in children are constant and vigilant monitoring by parents and loved ones. The child should be explained in advance the rules of behavior on the road and safety precautions during active games in the yard.

When engaging in traumatic sports, it is mandatory to wear a protective helmet.

Conclusion

With a concussion in a child, in no case should you engage in self-diagnosis and self-treatment. Only an experienced doctor can make a correct diagnosis after a series of instrumental diagnostics. If you do not follow the recommendations of a specialist, then there are high risks of developing serious complications.

Content

Mobile, inquisitive children who do not have a sense of self-preservation often find themselves in emergency situations. Injuries, bumps and falls that accompany them from an early age sometimes end in a concussion. What is the danger of such a condition, how to avoid its occurrence? Parents should know the symptoms of injury in order to promptly call a doctor and provide first aid to the child.

What is a concussion in children

An accident, hitting the head during a fall, often leads to a closed craniocerebral injury (TBI). A mild reversible form of TBI, accompanied by damage to tissues, blood vessels, membranes, nerves, is called concussion. In this case, the bones of the skull remain intact. The condition is characterized by symptoms:

• short-term loss of consciousness;
• headache;
• tinnitus;
• pallor;
• anxiety;
• sleep disturbance;
• dizziness;
• lethargy.

In children, concussion has its own characteristics associated with the formation of the organ. Its high plasticity provides compensation in case of injury, but impaired brain function in childhood causes severe consequences in the future. Changes in tissues are noted at the molecular-cellular level. There are several theories explaining the ongoing processes. One of them is vasomotor. According to her, the concussion mechanism is associated with impaired cerebral circulation, which is caused by:

• vasospasm;
• ischemia (impaired blood flow) of the brain;
• hyperemia (overflow of blood vessels).

Medical science explains the processes that occur in a child during a concussion with such theoretical calculations:

• hydrodynamic - trauma provokes the rapid movement of cerebrospinal fluid, which causes stretching, irritation of nearby centers;
• vibrational - changes occur at the molecular level as a result of vibrations that propagate through the tissues during injury to the side opposite from the impact.

The reasons

Concussion in children is the result of their excessive activity, lack of parental control. Injuries appear from infancy. At this stage of development, the main cause of misfortune is the inattention, carelessness of adults who leave babies unattended. As a result, newborns fall:

• from strollers, beds;
• from changing tables, sofas;
• from the hands of the parents.

As the baby grows older, when the baby begins to walk independently, injuries occur when falling from a height of their height. The older the child gets, the more he learns the world while getting injured. Concussion in preschoolers is caused by blows to the head received during the game, violence against the child. TBI often occurs when falling from a height:

• roofs;
• slides;
• tree;
• window;
• fence;
• swing;
• stairs.

Schoolchildren and adolescents are characterized by their own provoking factors associated with carelessness, negligence. Head trauma at this age is caused by:

• clarification of relations in a fight;
• traumatic sports;
• riding a bike without a helmet;
• active physical education;
• jumping from a great height;
• strong vibrations on the swing;
• extreme entertainment;
• sharp braking;
• outdoor games associated with a collision;
• traffic accidents.

Concussion in babies can appear without a traumatic brain injury. Shaken baby syndrome is diagnosed before the age of four. Pathology develops with a strong external impact on the body, but without blows to the head. The reasons for this condition are:

• jumping from a great height with landing on your feet;
• child abuse;
• rocking the baby with sharp movements.

Degrees of expression

Symptoms of brain damage depend on the stage of the ongoing processes. Doctors define three degrees of severity of injury. With any of them, the child must be shown to the doctor. There are two stages of pathology without loss of consciousness:

• The first, mild, is characterized by mild symptoms that pass after a quarter of an hour. In this case, a slight headache, slight dizziness is possible.
• In the second degree, signs of pathology are observed for more than 15 minutes. The child is disorientated in space, nausea, vomiting, headaches begin.

The greatest danger is the third, severe degree of concussion, which is characterized by a fracture of the bones of the base of the skull, the formation of hematomas. The condition threatens to disrupt the functions of all body systems. In the third degree of TBI observed:

• unconsciousness for more than 15 minutes;
• weak breathing;
• impaired vision, hearing, speech;
• pupil dilation;
• amnesia;
• ear bleeding;
• increase in pressure;
• increased heart rate;
• increase in body temperature.

Symptoms

The baby's skull has bones that cushion when in contact with heavy objects. This protects the brain from irreversible consequences. Parents should carefully monitor the condition of children after an injury. Often the symptoms do not appear immediately, but after a few hours or even days. This is due to an imperceptible, short-term loss of consciousness. Clinical symptoms of concussion depend on age, wherein:

• They are difficult to determine in infants due to their similarity with signs of other diseases.
• Older children themselves can talk about their feelings.

Symptoms in pathology are diverse. There are single signs or several at once. After an injury, symptoms such as :

• cerebral - amnesia, loss of consciousness, dizziness, flies before the eyes;
• vegetative disorders - increased respiration, sweating, pressure surges;
• asthenic changes - palpitations, tinnitus, weakness;
• impaired coordination of movements.

First manifestations

Parents of a baby who has received a head injury need to know the first signs of a concussion in a child. This will help you get help in a timely manner. The initial manifestations of pathology are:

• vomit;
• pallor of the skin;
• sudden redness of the face;
• loss of consciousness;
• headache;
• change in the frequency of heart contractions - acceleration, slowdown;
• nose bleed;
• respiratory failure.

For infants after a concussion, an increase in motor activity, excitement. The kid screams a lot, cries, sleeps badly. Older children experience:

• loss of orientation in space;
• dizziness;
• sweating;
• hematoma on the head;
• desire to sleep;
• inability to concentrate;
• short-term blindness;
• noise in ears;
• lethargy;
• weakness.

It is important to pay attention to the pupils with a concussion in a child. He may have a lack of sensitivity to light, reactions to external stimuli. The following symptoms of the pathology of the state of the pupils are characteristic:

• motion desynchronization;
• reduction, increase in size;
• expansion, narrowing;
• twitching;
• involuntary movements;
• shape change;
• strabismus;
• difference in size is a symptom of severe injury.

late signs

If the parents did not notice the injury in the baby in time, did not go to the doctor, the symptoms become less pronounced. . late signs distinguished by frequent repetition, they wear a protracted form. Concussion watching :

• poor appetite;
• lack of interest in favorite things;
• sensitivity to light loud sounds;
• aching pain in the head;
• sleep problems;
• lethargy;
• mood changes;
• tearfulness;
• touchiness;
• vulnerability;
• increased sleepiness.

For a baby, the consequences of a concussion are manifested by refusal to feed, frequent regurgitation, anxiety, moodiness. Preschool children, adolescents often do not remember what happened to them. Trauma is characterized by secondary symptoms such as :

• photophobia;
• nightmares;
• lack of response to the appeal of parents;
• irritability;
• insomnia;
• severe fatigue;
• irascibility.

Dangerous manifestations

Pediatricians draw the attention of parents to symptoms that require immediate medical attention. Timely assistance reduces the likelihood of subsequent complications. Calling an ambulance is necessary for such dangerous manifestations of a traumatic brain injury as:

• visual impairment - blindness;
• loss of consciousness;
• dizziness;
• increased sweating;
• facial asymmetry as a result of ligament tension;
• reducing the eyeballs to the bridge of the nose;
• retraction of the tip of the tongue;
• temperature rise;
• vomit.

Signs of a concussion in a baby

The peculiarity of the structure of the skull of a newborn - five bones that have not yet fused - protects his brain from severe injuries. Concussion at this age is difficult to diagnose, because. symptoms are similar to other pathologies. Although there is no loss of consciousness, after a severe injury, the baby becomes capricious, sleeps poorly, cries a lot. Signs of a serious pathology signal:

• noticeable swelling of the fontanel;
• a sharp decrease in reflexes;
• restless behavior;
• eye movement disorder
• frequent regurgitation;
• pale skin;
• twitching of limbs;
• increased drowsiness;
• refusal to eat.

In children under three years of age

Babies at that age can't properly express how they feel after they've been hurt. Attentive parents should notice the symptoms of a concussion in order to see a doctor in time. Signs of injury in three-year-olds:

• capriciousness;
• sleep problems;
• pulse instability;
• refusal to eat;
• disorientation in space;
• temperature rise;
• nausea;
• pallor of the skin;
• dizziness;
• repeated vomiting.

At an older age

Preschoolers and older children may complain about their condition after a concussion. This age is characterized by loss of memory at the time of the incident, impaired consciousness, confusion, deafness. Notable symptoms of pathology:

• pressure in the eyeballs;
• cold sweat;
• pallor;
• dizziness;
• vomit;
• tinnitus;
• weakness;
• drowsiness;
• slow reaction to others;
• apathy;
• palpitations;
• constant feeling of nausea;
• headache;
• hypotension;
• weakness.

What to do before the doctor arrives

Parents should carefully consider the condition of the baby after the injury. It is unacceptable to panic, fuss, upset, frighten him, it is advisable to ask about the symptoms, the causes of what happened. It is required to call an ambulance, before the arrival of which it is forbidden :

• self-medicate;
• shake the little one to bring him to life when he loses consciousness;
• put it on your back;
• leave unattended;
• give painkillers;
• transport yourself to the hospital.

If there was a loss of consciousness or vomiting began during a concussion in a child, until the doctors arrive, it is necessary to put the victim on his side. The knees should be bent, the arms should be under the head, the baby needs to take a stable position. Parents need to do the following:

• inspect the head for damage;
• if necessary, treat the wound with an antiseptic - hydrogen peroxide, Chlorhexidine;
• make a dressing;
• apply cold to the injury site;
• prevent falling asleep;
• limit mobility;
• control the state.

Parents should master the techniques of artificial respiration, indirect heart massage, if there is a need for resuscitation before the arrival of an ambulance. They should:

• in the absence of loss of consciousness, put the victim, cover with a blanket, the head should not be lower than the body;
• measure the pulse;
• check breathing, heartbeat;
• examine the child for injuries, fractures of others from parts of the body;
• find out the details of what happened from the witnesses.

Diagnostics

A small person who has received a brain injury is being examined by a pediatrician, who sends him for a consultation with a pediatric traumatologist, surgeon, and neurologist. For diagnosis, a blood test is prescribed, an examination of the fundus by an ophthalmologist. To clarify the condition, instrumental studies are carried out:

• Neurosonography. It is performed at the age of up to two years, with the help of ultrasound it reveals hemorrhages, hematomas, edema.
• Ultrasound - determines the state of brain tissue.

For a grown-up baby, studies are carried out to assess the severity of well-being after a concussion. Several types of checks are used. Doctors prescribe:

• radiography - reveals fractures of the bones of the skull;
• MRI (magnetic resonance imaging) - shows the presence of neoplasms, hemorrhages;
• electroencephalography - determines areas of the brain with increased excess activity;
• lumbar puncture - sampling of cerebrospinal fluid for research;
• echoencephalography - finds out the state of the ventricular system of the brain, the presence of displacements, hematomas.

Treatment

To avoid complications, the baby, who was injured at the age of 6 years, is in the hospital under the supervision of doctors. After examination, diagnosis, treatment is carried out. If abrasions, wounds are observed, processing and bandaging is performed. Concussion therapy includes:

• bed rest;
• applying cold to the injury site;
• psycho-emotional peace;
• hyperbaric oxygenation (saturation of tissues with oxygen).

The task of drug treatment is to improve metabolic, energy processes in the brain, prevent the appearance of edema, and normalize the ratio between excitation and inhibition. For this, doctors use drugs:

• nootropic;
• potassium-containing;
• sedatives;
• antiallergic;
• painkillers;
• diuretics;
• stopping vomiting;
• vitamin complexes.

Treatment continues after discharge from the hospital when the threat of complications has passed. At home, a two-week bed rest is mandatory. The treatment regimen involves:

• continuing to take prescribed medications;
• restriction of mobility;
• organization of a calm environment;
• exclusion of bright, sunlight;
• refusal to watch TV;
• cessation of computer games.

Preparations

Medications in the treatment of concussion relieve unpleasant symptoms, restore brain function, improve the general condition of the patient, and help eliminate the risks of injury consequences. The therapeutic regimen includes drugs:

• nootropics - improve cerebral circulation, tissue nutrition (Cavinton, Pantogam);
• diuretic - prevent the development of edema (Furosemide, Diakarb);
• sedatives - relieve excitability (Fenibut, Tenoten for children);
• containing potassium - regulate pressure, prevent fatigue (Panangin, Asparkam).

To speed up recovery, children are prescribed vitamin complexes - Suprastin Kids, Pikovit; Ascorbic acid. Depending on the symptoms, doctors recommend the following medications:

• painkillers (Sedalgin, Baralgin);
• counteracting vomiting, nausea (Cerukal);
• antihistamines - soothing, having a hypnotic effect (Suprastin, Diazolin).

The drug Pantogam is approved for the treatment of infants from the moment of birth, is available in the form of a sweet syrup. The following features are characteristic of a nootropic agent:

• action - improves brain function, memory, has an anticonvulsant, sedative effect;
• applied at a dosage of up to 30 ml per day, inside;
• the course of treatment lasts up to six months, is determined by the doctor individually.

The children's version of the drug Tenoten in the form of lozenges is prescribed from the age of three. When using the tool, it is important to take into account:

• therapeutic effect - the drug reduces anxiety, calms, relieves depression, irritability; as a result of therapy, the supply of brain tissues with oxygen improves, blood circulation is activated;
• form and dosage of application - 1 tablet, three times a day after meals;
• duration of therapy - up to three months, is regulated by the doctor in accordance with the patient's condition.

Forecast and consequences

If, with a mild traumatic brain injury, the parents turned to the doctor on time, a full course of therapy with the use of drugs eliminates the risk of developing long-term consequences. Concussion of the middle, severe stage can lead to the appearance of:

• senile dementia (dementia);
• hypertensive crises;
• threats of termination of pregnancy due to high blood pressure;
• neuroses with tics, obsessive movements;
• frequent dizziness;
• memory impairment;
• hallucinations;
• insomnia;
• convulsions.

An injury that has not been treated in time, which happened in childhood, can cause unpleasant complications in later life. Common consequences include:

• weather dependence;
• development of phobias;
• reduced concentration of attention;
• postconcussion syndrome (contusion, prolonged symptoms);
• increased emotional excitability;
• vegetovascular dystonia;
• asthenic syndrome (decreased performance, weakness);
• tendency to depression;
• sensitivity to the development of infections;
• speech disorders;
• headache;
• anxiety;
• migraine;
• epilepsy.

Prevention

To avoid craniocerebral injuries, you need to follow safety precautions at home, on walks and teach this to children. Unacceptable even for a short time leave babies unattended on high surfaces– changing tables, sofas, in strollers. Injury prevention includes:

• constant parental supervision of young children;
• creation of house fences near stairs, protruding elements;
• talking with the child about the rules of the road.

A kid, starting from preschool age, should know how to behave on a walk, in in public places. Parents should:

• explain the need for self-preservation;
• to instill prudence;
• explain the dangers that lie in wait for the child on the street;
• learn to solve problems without the use of force;
• when practicing traumatic sports, use a helmet as a means of individual protection.

Video

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

How dangerous is a concussion for a child?

A concussion is a mild degree of brain damage that is not accompanied by fractures of the bones of the skull. In children, such injuries are very common, and with the right approach, complications rarely occur. A distinctive feature is a brief loss of consciousness after the impact. Changes in the brain occur at the cellular level and are not detected in studies.

Concussion is a common occurrence among children, which can lead to serious consequences.

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 may report how they feel, and the 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 treatment in a hospital.

Classification

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

1. brain injury - dangerous state causing his edema. It can occur with both open and closed trauma. Provokes an increase in intracranial pressure, requires immediate medical attention.
2. A skull fracture is a no less serious injury that can lead to 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.

Three degrees of severity of concussion are classified:

1. Easy - consciousness is absent for no more than 5 minutes;
2. Medium - loss of consciousness from 5 to 15 minutes;
3. Severe - prolonged lack 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 development factors

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

Infants who are not yet walking often suffer from parental inattention. The fourth and fifth months are especially dangerous, when the child is just starting to roll over on his stomach. Adults may simply not expect this from the baby, and leave him unattended on the couch, changing table or other elevated position.

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

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

Children are more prone to head injuries as it is proportionately larger and heavier than adults. Among other things, in a child, the fear of falling or damaging something is not yet fully realized, which contributes to the search for new heights. At a younger age, the baby still cannot substitute his hands in time during a fall from a height, which also favors a “landing” on his head.

Symptoms

Small children often fall and hit their heads. It is important to remain calm at such moments and objectively assess the situation. Knowing the symptoms, you can easily identify a head injury. In other cases, do not 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 blow. When the child comes to, he may not remember a few minutes before the fall. Other main symptoms of brain injury are:

• vomiting, most often multiple (if the child vomited only once, this may be the body's reaction to stress);
• confusion (inadequate answers to simple questions, lack of understanding of what is happening);
• post-traumatic blindness (a rare occurrence, occurs only in children, disappears after a few minutes or hours);
• headache;
• dizziness;
• drowsiness;
• apathy or excessive excitement;
• capriciousness.

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

With a concussion, all symptoms resolve themselves after a few days, if you follow the recommendations of doctors and take the necessary measures in time.

Diagnosis and differential diagnosis

It is impossible to diagnose a concussion with the help of any research, so the diagnosis is made on the basis of the overall clinical picture and symptoms. The sequence is always the following: the child hit, lost consciousness, symptoms appeared.

The symptoms of a concussion in a child must be reacted with lightning speed

Diagnostic measures in a hospital are carried out in order not to miss more severe injuries. The following tests may be ordered:

1. X-ray of the head. Carried out to assess the condition of the bones of the skull, this is the simplest and most mandatory 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 condition of the cranium and brain matter. However, this method is not always used due to the lack of equipment in the hospital.
4. Magnetic resonance imaging (MRI). Such a study is rarely performed for head injuries, as it is very expensive. The method is accurate, it helps to detect any, even the most insignificant damage. An MRI may be prescribed if concussion symptoms persist for a long time, despite treatment and compliance with all doctor's recommendations.

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

Treatment

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

When diagnosing a concussion in children, treatment in a hospital is strongly recommended. First of all, this allows for medical supervision during the first days after the injury. And also contributes to the child's stay in a calm environment with an established regimen. Parents may 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 a blow to the head there was a loss of consciousness, it is necessary to lay the child on its side. If there is bleeding, it is stopped with an ice compress. 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 his side.

When the baby came to his senses, he must be reassured and not allowed physical activity. It is important not to let him fall asleep immediately after the injury for at least an hour. In this way, possible violations can be detected.

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

If you suspect a concussion, be sure to call an ambulance. Even if it is a "false alarm", it is better to play it safe.

Treatment with drugs

Therapy in the hospital and at home is aimed at preventing possible complications. The following groups of medicines are usually used:

Related measures

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

Watching TV, sitting at a computer, using any other gadgets is completely excluded. The eyes should not strain 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 for the duration of treatment. It is not recommended to use:

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

These foods increase intracranial pressure and promote fluid accumulation, which can cause cerebral edema. The influence of food is not too great, but it will not hurt to adhere to such a diet for several days.

Sequelae of concussion in children

In most cases, such an injury does not cause serious complications. Subject to the regimen and recommendations of the doctor, 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 general well-being;
• irritability, capriciousness;
• lethargy;
• frequent headaches;
• insomnia and other sleep disorders;
• periodic causeless bouts of vomiting;
• epileptic seizures are very rare.

In rare cases, such complications can disturb 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.

Prevention

With children, it is difficult to take sufficient 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 the house where there is a child before three years. And also restrict access to any elevations - window sills, tables, cabinets, etc.;
• talk with older children, explain the danger of injury;
• try not to let a large number 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, starting with the first steps, fall and hit their heads. It is not necessary to run to the hospital every time or call a doctor. The main thing is to observe the behavior of the child, not to panic. The kid, seeing the excessive anxiety of the parents, may be frightened himself. For any sign or even suspicion of a concussion or other traumatic brain injury, medical attention is needed. With timely admission to the hospital, the risk of complications is practically absent.

Degrees of concussion

Traumatologists distinguish three degrees of severity of TBI:

1. Light. After the impact, there is tinnitus, dizziness for no more than 15 minutes. In the evening, the head may hurt a little, the child will fall asleep faster than usual. The injury does not cause serious damage to health.

1. Average. Obvious impact effects are observed within 20 minutes to several hours. They are expressed in the fact that the child is maladjusted in time, space, feels nausea, weakness. May hurt and dizzy. Light and moderate severity are not accompanied by loss of consciousness.

1. Heavy. It occurs due to a powerful blow, a fracture of the bones of the skull. The infant or preschooler loses consciousness. Fainting lasts 2-20 minutes. After the brain is turned on, children feel severe weakness may not remember what happened, they do not immediately answer questions, the pupils dilate, blood oozes from the wound. In this case, children need urgent help.

Important! It is impossible to determine the stage of the severity of the stroke by the first symptoms. Immediately the child may feel satisfactory, and after a couple of hours the condition worsens. The conclusion is made on the basis of long-term observations, surveys.

First aid

Before the ambulance arrives, adults need to provide first aid to the fallen child. The algorithm of actions depends on the severity of the injury.

With a slight bruise without loss of consciousness, you need:

1. Lay the child on its side.
2. Examine the head.
3. If the condition allows, take to the hospital yourself.

Driving should be slow and smooth jerky movements, horse racing is contraindicated for a baby with a concussion.

First aid for moderate and severe injuries is as follows:

1. Lay the victim on his side, bend the arm at the elbow, the palm should lie under the cheek.
2. Bend your legs at the knees.
3. Fix the position, do not allow getting up and unnecessary movements.
4. Cover with a blanket.
5. Call an ambulance.
6. If vomiting begins, help the baby not choke on the outgoing food.
7. Treat abrasions with Chlorhexidine.
8. Apply ice to bruises and bumps.
9. Stop the blood with a cotton swab.
10. After the child comes to his senses, ask about how he is feeling.
11. Don't let me sleep.

If the skull fracture is severe, the child may go into shock. In this case, it is important to provide first resuscitation assistance:

1. Check breathing, pulse.
2. If necessary, make artificial respiration, heart massage.
3. Inspect the limbs, torso for other injuries.

Important! It is impossible to give any medicine to a child after a fall; it is impossible to give painkillers injections. Wait for the doctors to arrive.

What not to do with a concussion

Children's traumatism is especially dangerous with consequences. In order not to aggravate the situation, follow the recommendations of doctors while waiting for an ambulance:

• Do not place an injured child on their back.
• Do not lower your head below your body. You need to take the child in your arms so that the skull is in line with the neck.
• Don't slap in the face.
• Don't shake your shoulders.
• Do not treat wounds with alcohol.
• Do not leave the fallen unattended.
• Do not panic.
• Do not Cry.
• Don't make sudden movements.
• Do not let yourself rise.

Remember! If you have witnessed an accident, want to help people, do not budge victims with visible head and neck injuries. The impact damages the vertebrae. Any movement of the body without fixing the spinal column worsens the condition. Call rescuers and wait for help without leaving the scene of the accident.

When to call an ambulance

Definitely worth calling an ambulance if:

• The kid managed to fall from a height, hit a solid barrier, as a result he lost consciousness.
• There was blood on the child's head, dents, bruises and bumps of bright color quickly formed.
• 1-2 hours after a light, in your opinion, stroke, the baby vomits, he really wants to sleep, complains of headache, nausea.
• The children hit hard on a walk in the preschool. This point is important not to forget kindergarten teachers.

In other cases, objectively assess the well-being of the babies, contact the polyclinic for a safety net for a consultation or examination.

Which doctor to contact

A child with a mild head injury is seen by a pediatrician. He can also diagnose complications, clarify the consequences of a blow with the help of hardware studies. The pediatrician is obliged to refer the parents and the baby to narrow specialists:

• Traumatologist. If the degree of severity of the injury is incorrectly assessed by the parents. For example, in a child, not stage I, but stage II concussion, the cervical spine is affected. An examination by a doctor of narrow specialization, referral for X-ray, ultrasound, MRI is necessary.
• Lore. Takes part in the treatment of the victim, if the blow fell on the ear, temple, an ichor is released from the auricle, the child began to hear poorly.
• Oculist. Visual acuity is affected by blows to the back of the head, concussions of the II–III degree.
• Neurologist. If nerve endings are damaged. After the impact, the baby develops numbness of the limbs, tremor, irritability, hypotension.

Note to strict parents! slight concussion Small child can get because of the slap, shaking by the shoulders. You can see what the brain looks like at the moment of thrashing in the video.

Diagnostics

An additional examination of even a mild stage of concussion in babies up to a year old will definitely not be superfluous. Parents should take care of this. Ask your pediatrician for the right directions to rule out a misdiagnosis.

With II–III severity of closed and open injuries, examinations are carried out in a hospital without fail. It:

1. X-ray. It is always prescribed regardless of the condition of the baby. Helps to recognize the symptoms of severe impacts: cracks, broken bones.
2. Neurosonography. It is done for kids from birth to the second year. The examination is carried out through the fontanel. Ultrasound can reveal latent edema, hematoma, disorders of brain tissue structures.
3. CT scan of the skull, brain. With the help of computed tomography, it is much easier to identify the clinical picture. The result is processed by the program, does not require patient preparation. The picture shows swelling, hematomas, shifts of the substance inside the cranium.
4. MRI. Helps to determine the nature of TBI, assess the state of brain structures. Consequences for the bones of the skull, the presence of small cracks will not be seen. It is rarely used for one-year-old children, since it requires the introduction of anesthesia.
5. Puncture. Taking fluid from the spinal cord and brain is a painful procedure. It is prescribed to detect brain inflammation, meningitis, hemorrhages. Examination requires special indications.
6. Echoencephalography, electroencephalography. Outdated methods for diagnosing concussion severity. Provide indirect information about the nature of the damage. They are rarely used if there is no technical possibility to do MRI, CT.

Treatment Methods

The affected child will undergo a full course of recovery in three to four weeks. The therapy is divided into two stages:

• in the hospital immediately after injury;
• at home.

Urgent treatment in the hospital

Therapy of the second and third stages of TBI is carried out in a hospital. With moderate severity, the duration of hospitalization varies from five days to a week. Being under the supervision of a doctor is necessary for the following reasons:

• Concussions are dangerous because of the consequences that appear after the impact. It can be swelling, hemorrhage, deterioration, even coma.
• The child needs rest, lack of activity. A fidget at 1-2 years old will not be able to endure bed rest at home.
• It is important for parents to receive complete information about the dosage of drugs, diet, regimen. The attending physician will tell and show what to do with the baby for further recovery.

To recover and maintain a satisfactory state of health, small patients are prescribed medication:

• Diuretic drugs. Necessary for removing excess fluid from the body, insurance against edema. Children at the age of two are prescribed Furosemide, Diacarb.
• Sedatives to calm the nervous system, improve sleep. This is a tincture of valerian, Phenazepam.
• To stimulate blood circulation, the child receives nootropics in tablets: Pantogam, Piracetam, Glycine.
• Painkillers are taken until the migraine disappears. These are strong drugs "Baralgin" or "Sedalgin".
• With constant nausea, Cerucal is prescribed.
• To restore the level of potassium in the blood, normalize the work of the heart and blood vessels, potassium preparations are prescribed: Panangin, Asparkam.
• To restore pressure, the operation of vessels with a dropper with magnesia.
• After a severe bruise, the temperature may persist for 1-2 days. You will need antipyretics.
• Vitamins. The body needs glutamic, hopantenic, ascorbic acids.

After the end of the acute period, it is useful to undergo physiotherapy:

• Hypothermia. Applying cold compresses to the site of injury, swelling.
• Inhalation with humidified oxygen.
• Soothing aromatherapy, baths.

Therapy at home

After discharge from the hospital, parents must follow the following doctor's recommendations for aftercare of a sick baby. Care should begin immediately upon arrival home:

• Provide emotional and physical rest for 2-3 weeks.
• Not allowed to watch TV, play computer.
• Follow a diet. Food should be light, small portions four to five times a day.
• Take medication at the prescribed dosage.
• Seek help if symptoms return.
• It is important not to hit your head again.

Could there be consequences

Parents after receiving a concussion of the brain of any severity feel very anxious. They are concerned about the future health of their son or daughter. It is important to know after what time you can not worry about the consequences and complications, what will happen to the child if he hits his head again. We answer in order.

Common consequences include: pathological conditions varying degrees of severity:

• violations of memory, attention, speech;
• migraine;
• inhibition of speech, actions;
• weather dependence;
• sleep disorders;
• neuroses;
• tics;
• pressure surges;
• convulsions;
• decrease in working capacity;
• tendency to depression;
• epilepsy;

It is important to understand that the consequences of a strong blow, and especially repeated injuries, may not occur immediately. Even after 10 years, if an adult experiences a deep shock, suffers from an infection, meningitis, becomes overly excited, or uses drugs and alcohol.

When a child is one and a half years old, no doctor can accurately check and make sure that the consequences will not affect the little patient in the future.

On a note! Dr. Komarovsky believes that even the correct medical treatment of an injury of III (severe) degree is not able to prevent a 100% high risk of complications. Parents need to protect the baby from stress, overheating and repeated blows to the head. In this case, you will have to face the consequences much less often.

See in more detail what the famous doctor says about this in his program:

Whether or not there will be consequences depends on the following factors:

• The age category of the victim. How younger child, the more serious complications and distant echoes of trauma can be.
• How quickly adults sought medical help. Treatment and timely surgical intervention reduce the risk of consequences.
• Methods and completeness of the therapeutic course. If the vessels, bone tissue are restored, you will not have to remember the injury in the future.
• How much bed rest was observed, doctor's recommendations after discharge.

Recognizing a concussion on your own, without medical help, is very difficult. And you don't have to. If there is a reason to doubt the health of the child after an active walk, a fall, and even more so a blow, go to the doctor. Trauma centers work around the clock, you should not wait for the next morning or day.

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