A cerebral compression is a contraction of the brain. It represents a third degree of traumatic brain injury.
What is a Compressio cerebri?
Compressio cerebri is the medical name for a severe form of traumatic brain injury (TBI). The brain is crushed by internal or external pressure due to swelling or bleeding in the brain. Doctors also speak of a traumatic brain injury 3. Grade that receives 3 to 8 points in the Glasgow Coma Scale.
Other forms are concussion (commotio cerebri), which is a traumatic brain injury of the 1st degree, as well as brain contusion (commotio cerebri), also called SHT 2nd degree. In addition to crushing the brain, minor bleeding is also possible.
It is typical of a Compressio cerebri that injuries not only occur at the point where the force was applied, but also in the areas on the opposite side.
It is not uncommon for additional injuries to occur when the brain is crushed. Basically, traumatic brain injuries such as Compressio cerebri are relatively common injuries. In Germany, around 250,000 citizens suffer a traumatic brain injury every year. Around five percent have severe brain contusions that can result in a permanent coma or, in the worst case, death.
The brain is surrounded by the skull bone, which serves to protect it. The front part of the skull is made up of the upper jaw, lower jaw and bony nasal and eye sockets. Most of the brain is covered by the back of the skull. On its underside, the brain is surrounded by the base of the skull.
There is an opening that acts as a passage for the spinal cord. If these structures are affected, it is referred to as a traumatic brain injury. Most of those affected suffer a traumatic brain injury or compressio cerebri as a result of accidents.
Most of these are falls in sports in which the injured person does not wear a protective helmet, such as skiing or cycling. But brain contusions can also be suffered in the context of risky work activities. In addition to the blunt effect of violence such as falls and blows to the head, it is also possible to drill through the skull with sharp objects.
Around a third of all traumatic brain injuries are the result of traffic accidents. About 30 percent of all patients have additional injuries, which doctors call multiple trauma.
Symptoms, ailments & signs
In the case of Compressio cerebri, the symptoms of the injury are more pronounced than in the case of a concussion or contusion, but generally correspond to their symptoms. The resulting loss of consciousness lasts for at least 60 minutes and can sometimes even last a few days. The unconsciousness is caused by entrapment of the brain caused by bleeding or edema.
Furthermore, the affected person suffers gaps in their memory, which, as in the case of a concussion, are not limited to the phase immediately after the injury, but also extend to the time before the accident, which is known as retrograde amnesia. In addition, symptoms such as hemiparesis (hemiplegia), psychological changes or language problems can occur as part of a contusion of the brain.
If there is a permanent increase in pressure and an entrapment of the brain, there is a risk of a prolonged coma. In the worst case, death can also occur. There is also a risk of chronic brain injury, although this does not always occur. With a Compressio cerebri, the patient often suffers further injuries. These include skull fractures or a subdural hematoma (bruise below the meninges).
Diagnosis & course
The diagnosis of Compressio cerebri is based on the Glasgow Coma Scale (GCS). It forms a point system that includes the three most important human reactions. These are the opening of the eyes, movements and verbal communication. The maximum number of points in the GCS is 15 points, while the minimum is 3 points.
A brain squeeze is when a number of points between 3 and 8 points is achieved. The reactions of the pupils and muscle tone are also important. The most important examination methods for a traumatic brain injury include imaging procedures such as x-rays of the head and computed tomography (CT), which can be used to determine tissue damage, bleeding spots and signs of intracranial pressure.
Magnetic resonance imaging (MRI) of the head is sometimes useful. The course of a brain contusion depends on its extent. In the case of cerebral compression, for example, there is substantial damage to the brain. In most cases, however, the neurological damage disappears completely.
In most cases, the Compressio cerebri leads to a relatively long loss of consciousness that lasts for at least an hour. Complications can mainly occur if the cerebral compression has occurred as a result of an accident or a blow to the head. However, these then depend on the exact accident occurrence. Often there is also bleeding on the head or internal bleeding.
It is not uncommon for the patient to be unable to remember what happened shortly after the accident. Above all, this can prevent the reconstruction of the course of the accident. The bruising can cause paralysis and malfunctions in various areas of the body. There are also mental problems, such as language disorders or a word finding disorder.
In the worst case, the patient is paralyzed and can no longer move independently. If the brain becomes too pinched, the loss of consciousness can result in a coma, ultimately leading to death. Treatment is usually symptomatic, primarily treating pain.
If the patient cannot remember how the accident happened, it is usually monitored further and all functions of the body are tested. Certain paralysis or other disorders are treated therapeutically. There are no further complications. However, no guarantee can be given that the complaints can be completely treated.
When should you go to the doctor?
In the event of a Compressio cerebri, the emergency doctor must be called immediately. Visible skull fractures and loss of consciousness are clear signs that a severe traumatic brain injury is present. Only a doctor can determine whether this is a contusion of the brain or some other injury.
Therefore: after an accident or fall, alert the rescue service immediately and, if possible, provide first aid. The injured person must be treated as quickly as possible and then taken to a hospital, where the contusion of the brain can be clarified and intensive medical treatment.
If there are complications in recovery, the care staff or doctor should be consulted immediately. If the person concerned has memory gaps, therapeutic help must be sought. In the case of language problems or psychological changes, further measures must be taken to limit the complications as far as possible. In the case of severe complications such as hemiplegia, support should be sought at an early stage. The relatives or the person concerned must also initiate physiotherapy measures and seek support in everyday life.
Treatment & Therapy
Treatment of cerebral compression also depends on the extent of the injury. While a few days of bed rest are usually sufficient for a mild concussion, the patient has to go to the hospital if the brain is crushed. In the event of unconsciousness, vital functions such as circulation and breathing are secured.
If there is an open traumatic brain injury, a surgical intervention is necessary, which also applies in part to cerebral haemorrhages and skull fractures. It is also important to monitor the patient closely for a few days. If the clouding of consciousness persists for a long time, the patient is sometimes treated in the intensive care unit.
If there is a risk of cerebral edema, dehydrating drugs must be administered. For further treatment of a Compressio cerebri, admission to a special clinic is considered useful. There you can fall back on specialists, specialized occupational therapists, speech therapists and physiotherapists.
Outlook & forecast
The prognosis for cerebral compression depends on various factors. The severity of the injury as well as the present cause are decisive for a successful healing. In addition there is the age of the patient and the duration of the experienced unconsciousness. In many cases, the extent of the cerebral compression is only apparent after several years. The attending physicians can indicate tendencies shortly after the onset of the contusion of the brain. However, any permanent damage will only be evident after 2-3 years.
As a result of medical progress, various therapy methods have been developed in recent years that contribute to a significant improvement in health. With regular exercises and targeted methods, the intensity of paralysis or unsteady gait can be alleviated.
With the Compressio cerebri there is the possibility of permanent impairment. These have a strong influence on the quality of life and often lead to a restructuring of everyday life and work. The longer the person has been unconscious, the more unfavorable is the further development. If there were respiratory disorders, this also plays a major role in the possibility of a cure. The disease triggers a stressful experience and excessive demands in many patients. The prognosis worsens as soon as a mental disorder occurs.
The best preventive measure against traumatic brain injury or cerebral compression is to wear a protective helmet. Above all, risk groups such as inline skaters, cyclists, motorcyclists and climbers should use these.
Follow -up measures are particularly important in the case of cerebral compression or contusion of the brain as a result of a traumatic brain injury. Above all, however, professional acute treatment of the severe symptoms is required first. The question is whether the patient can even survive the serious consequences of the crushing of the brain. Compressio cerebri is the result of a severe, often accidental, traumatic brain injury or increased intracranial pressure due to other causes.
In the case of particularly severe brain trauma, a permanent coma is possible. Many sufferers cannot be saved if they have severe cerebral compression. They die from the consequences. In these cases, follow-up care is done. In the event of survival in a coma, extensive treatment and care measures are necessary as long as the patient survives. This is the case in five percent of all cases of traumatic brain injury. There are often multiple trauma. This complicates the treatment as well as the aftercare.
Depending on the patient’s condition, follow-up care for Compressio cerebri can be very extensive. In many cases, medically trained staff is required in order to place the follow-up measures in professional hands. Physiotherapy, speech therapy, or breathing therapy are possible measures. Often the necessary follow-up measures for severe cerebral compression can only be carried out in a clinical setting. Even after acute treatment, complications can arise that must be treated immediately.
You can do that yourself
If the brain is damaged, the possibilities for self-help are limited. Nevertheless, the person concerned can make sure that he does not subject his head to jerky movements. Rapid turning movements, hopping, jumping and running should be avoided.
In order for brain swelling to recede as quickly as possible, vibrations of the head of all kinds must be reduced or completely prohibited. Sports activities can only be carried out to a limited extent until recovery. Participation in ball sports may not take place under any circumstances.
When driving a car or bicycle, a calm and very calm driving style should take place so that emergency braking or vibrations caused by bumps are avoided. The head should be relieved as often as possible and should only be exposed to slow movements. Regular breaks and laying your head down support the healing process as they help to relieve the strain.
Exhausting cognitive stress should also be avoided. Discussions, intellectual tasks or stress increase the activity of the brain and thereby stimulate the blood circulation and the supply of the nerves. It is also advisable if the sensory systems are not exposed to heavy loads. Reading in low light or listening to loud pieces of music lead to increased activity of the muscles, nerves and the brain areas involved in processing. On the other hand, relaxing and calming environmental influences are helpful.