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• How Is a Concussion Diagnosed?
• Concussions with High Risk for Needing an Operation
• Concussions with Medium Run a risk for Brain Injury
• A Head Injury Tin can Be Hard to Diagnose Topic Guide

How Is a Concussion Diagnosed?

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Pocket-sized head injuries are a routine occurrence. From toddlers falling against tables, kids bumping heads playing ball, to an elderly person falling down, people often pb with their heads when they move most. Usually, a few stars are seen, a headache happens, and all is well. Sometimes it isn't then clear. The person may exist knocked out for a few seconds, may vomit, and perhaps may have some loss of memory, simply by the fourth dimension the doc visits the bedside, everything is back to normal. The diagnosis of a concussion is made.

Only now what? What do you exercise with somebody who acts and appears normal, fifty-fifty though there was a history of a head injury? Who will have bleeding in their encephalon and who won't? Who needs a CT scan and who just needs to go home?

Less than a generation ago, CT scans didn't exist, and observation was the cardinal to head injury care. If the patient did well, they went habitation; if not, a neurosurgeon was called in to evaluate the patient. At present, CT scans can exist found in even the smallest infirmary, but but considering the machine is at that place doesn't mean that information technology should be used indiscriminately. Putting aside the cost, the radiation risk of an unneeded exam is significant.

While scientific studies can provide guidelines every bit to who needs imaging studies, patients and their families want more than the doctor's opinion; they want the reassurance of hard bear witness similar an Ten-ray or CT. Every case needs to be considered individually. All the same, hither are some guidelines that a doctor may employ to decide: "To CT or no CT; that is the question."

The Canadian CT Head Rule states that a CT browse is required if any of the post-obit exist:

Concussions with High Hazard for Needing an Operation

• the person is not fully awake and responsive inside 2 hours after injury
• there is a suspected depressed skull fracture
• there is a suspected fracture of the base of the skull (bruising of both optics, blood behind the eardrum, or spinal fluid running from the ears or olfactory organ)
• vomiting occurs more than 2 times
• the patient is older than 65 years of historic period

Concussions with Medium Risk for Encephalon Injury

• amnesia (loss of retentivity) of before impact of greater than 30 minutes
• unsafe mechanism (being hitting by a car, being thrown from a car, falling more than 5 stairs)

The New Orleans Criteria state that a CT browse is required with any ane of the following findings in a person who is fully awake:

• headache
• vomiting
• older than age 60 years of age
• drug or booze intoxication
• amnesia
• visible trauma above the collarbone
• seizure

These rules all need to be applied based on the patient's specific situation. Communication amidst the medico, patient, and family allows the right handling pathway to be followed while hopefully coming together everyone's expectations.

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References

Medically reviewed by John A. Daller, Md; American Board of Surgery with subspecialty certification in surgical disquisitional care

REFERENCES:

Stiell IG, et al. The Canadian CT head dominion for patients with minor head injury. Lancet May 5, 2001;357:1391-six.
Stiell, IG, Clement, CM, Rowe, BH, et al. Comparison of the Canadian CT caput rule and the New Orleans criteria in patients with minor head injury. JAMA 2005; 294:1511.

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Source: https://www.emedicinehealth.com/a_head_injury_can_be_difficult_to_diagnose/article_em.htm

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