[Diagnosis and recovery time of brain concussion].
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AIM: Identification of risk factors for intracranial bleeding after minor traumatic brain injury. METHOD: The charts of 464 patients treated between January 1976 and December 1997 with the initial diagnosis of minor traumatic brain injury were reviewed. They were analyzed for clinical and diagnostic signs putting the patients at risk for intracranial bleeding. RESULTS: About two thirds of the patients (67.5%) were males, the average age being 36.1 years. Leading causes of accident were sudden falls (27.4%) and bike/autocycle crashes (24.8%). 30.4% of the patients were under the influence of alcohol. At the time of admission to the hospital 17.2% of the patients showed impaired consciousness and 12.5% presented neurologic signs. In ten patients an intracranial bleeding was found. All these bleedings were diagnosed at the primary investigation. DISCUSSION/CONCLUSIONS: Following groups of patients with traumatic brain injury have an increased risk for intracranial bleeding: Age > 60 and < 16 years, sudden falls, tachycardia, Glasgow-Coma-Scale < 15, impairment of consciousness, neurologic signs, fracture of the skull and patients suffering from coagulopathy. Drunk patients are difficult to judge; therefore, they should be handled as being at risk. Patients at increased risk should be observed on an intensive care unit whereas patients without those risk factors can be observed on a normal ward or, alternatively, discharged after reexamination and uneventful course after some hours.
A study is presented of the activity of superoxidedismutase and catalase in the brain and liver in the dynamics of mild head injury in experiments on rabbits. It was established that the activity of catalase in the brain show a three-times reduction within 15 minutes after the injury. The catalase activity in the liver remains practically unchanged. The activity of superoxidedismutase in the liver in the posttraumatic period does not differ from control values. In the brain superoxidedismutase activity reduces by 38% only on the 7 and 14 days after injury.
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