Shell-shock

Shell-shock Pathophysiology of concussion is a notion that has no organic lesion substrate. It represents an immediate loss, transitional state of consciousness, followed by a brief period of amnesia. Loss of consciousness is totally reversible and is accompanied by minor alterations of autonomic functions. From anatomical point of view, it produces a reversible membrane depolarization by blocking neuronal electrical conductivity, a phenomenon predominantly in the reticulated system in the brainstem ascending activation. Recent studies have shown that there are certain biochemical and ultrastructural changes in the brain, such as mitochondrial ATP depletion and destruction of local blood-brain barrier. It is generally easiest manifestation of head trauma that may be associated with any clinical syndrome and traumatic pathology of the disease. Concussion usually occurs upon impact with a blunt object or deceleration in road accidents, brain. Functional disorder is an expression of protective inhibitions supraliminara that suddenly occurs in the cerebral cortex following a supramaximale excitations. Pathophysiology, concussion develops through four stages: - Inhibition of the entire generation nevrax; - Gradual concentration and cortical inhibition of subcortical formations; - Inhibition of cerebral cortex isolated; - The total disappearance of inhibition and normalization of higher nervous activity and cortico-subcortical correlations.
Clinic The event features a concussion is a loss of consciousness as a result of inhibition supraliminare. Duration of loss of consciousness is variable from few minutes to several hours. Length correlates with severity of injury suffered. In concussion can occur during brief seizures or autonomic symptoms and signs as bradycardia, facial pallor, hypotension lipotimie with mild or diminished pupillary reactions. In terms of neurological patients no signs or symptoms. Postcomitional reactive syndrome, which occurs after regaining consciousness, include headache, dizziness, fatigue, vomiting, psychomotor agitation, disorientation, decreased performance at work. All these events are transient and do not leave scars. These accusations may exist in the case of a preexisting injury neurotic syndrome, in which case they continue, not injury related to production. Amnesia patient accused defective that after returning consciousness refers mostly to the period when trauma and posttraumatic unconscious. The impact of memory erased earlier sequences, including the time of manufacture. Improvements occur sequentially from the most distant events prior to the most recent injury. Sometimes there remain gaps around period involving injuries. There is a hysterical post-traumatic amnesia, which should be suspected based behavioral problems when they occur
The diagnosis of stroke is put back, after a period long enough to develop any symptom of a stroke. If there are some neurological then ruled out stroke. CT images and the MRI (magnetic resonance imaging) are usually normal. Approximately 4% of patients had a stroke at CT will see a subdural intracranial hemorrhage, epidural, or parenchymal.
Evolution of concussions is generally favorable, regresand symptoms gradually. In some cases, but may experience a gradual worsening of the patient's condition worsening disturbance of consciousness. This change indicates that organic disorders occurred. It is possible, more rare, like a concussion to pass in cerebral contusion.