Lost Concussion
Introduction
Introduction to Lost Concussion Lost turbulence refers to a labyrinth injury without a humeral fracture when the brain is closed, sometimes accompanied by a labyrinth and rupture. According to statistics, 40% of patients with concussion have lost their symptoms. There are mainly sensorineural deafness, tinnitus, nystagmus and balance disorders. When there are otoliths deposited in the posterior semicircular canal of the ampulla of the ampulla, there may be a typical benign paroxysmal positional vertigo. Symptoms of the disease mainly include sensorineural deafness, tinnitus, nystagmus and balance disorder. When there are otoliths deposited in the posterior semicircular canal and sacral calculi, there may be typical benign paroxysmal positional vertigo. It is often accompanied by concussion symptoms and psychiatric symptoms. Some of the wounded can recover from hearing. The vestibular symptoms usually disappear within one year. If hearing and dizziness often fluctuate, lymphatic fistula caused by rupture of the lost window should be considered. Cochlear sputum, increased perilymphatic sputum, increased cochlear and vestibular symptoms; threshold upper hearing function test, fistula test, position test and Romberg sign can be positive, vestibular function test often has varying degrees of decline, recent years The ear neurological examination, such as surgical exploration and tissue symptoms of surgical specimens, proves that the vestibular disorder after head trauma is not limited to getting lost, and the lesion of the eighth cranial nerve and the brain stem is about 50% of the lesion or brain stem lesion, so it is diagnosed. In order to get lost, the damage should be further determined. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: concussion, disturbance of consciousness, headache, nausea and vomiting, tinnitus, insomnia
Cause
Lost cause
Trauma factors (95%):
In the acceleration movement of the head injury, the hearing and vestibular terminal receptor displacement due to inertia, and the strong vibration wave transmitted to the inner ear through the skull are the direct cause of the labyrinth. The sudden increase of cerebrospinal fluid pressure during head trauma can be Peripheral lymphatic pressure is increased by the conduction of the volute guide tube or the inner auditory canal, so that the labyrinth [circular transmembrane and/or oval ligament] is ruptured, and the external ear canal or nasopharynx local pressure is broken when exploding or slapping Sudden rise, it can also be transmitted inward through the middle ear, causing the lost window to burst inward.
Other factors (5%):
The occurrence of this symptom caused by other diseases.
Prevention
Lost shock prevention
Avoid activities and movements that cause increased intracranial pressure, such as blowing nose, coughing, and exerting stools.
Complication
Lost complication Complications concussion disturbance disorder headache nausea and vomiting tinnitus insomnia
With concussion symptoms and mental symptoms. Mainly manifested in:
1. Disorder of consciousness: It is mild and short-lived, and can be as short as several seconds or minutes, but not more than half an hour.
2. Forgetting in the near future: After waking up, I can't recall the situation and the injury at the time of the injury, but I can clearly recall the things before the injury.
3. Other symptoms: often have headache, dizziness, nausea, anorexia, vomiting, tinnitus, insomnia, photophobia, inattention and unresponsiveness.
4. There are no positive signs in the nervous system examination.
Symptom
Lost symptoms, common symptoms, tinnitus, deafness, vertigo, hearing loss, concussion, nerve involvement, brain stem disease
There are mainly sensorineural deafness, tinnitus, nystagmus and balance disorder. When there are otoliths deposited in the posterior semicircular canal and sacral calculi, there may be typical benign paroxysmal positional vertigo, often accompanied by Concussion symptoms and psychiatric symptoms, some of the injured can recover hearing, vestibular symptoms can generally disappear within one year, if hearing, dizziness often fluctuates, should consider the lymphatic fistula caused by the rupture of the lost window, at this time there are many typical cochlear sputum When the amount of activity increases, the perilymphatic overflow increases, and the symptoms of the cochlea and vestibule can be aggravated; the threshold upper hearing function test, the fistula test, the position test and the Romberg sign can be positive, and the vestibular function test often has different degrees of decline. In recent years, surgical exploration And the ear neurological examination such as the tissue symptoms of the surgical specimens proves that the vestibular disorder after head trauma is not limited to getting lost, and the lesion of the eighth cranial nerve and the brain stem is about 50% of the lesion or brain stem lesion, so when the diagnosis is a labyrinth The damage site should be further determined.
Examine
Lost shock check
Threshold upper functional test, fistula test, position test and Romberg sign.
Diagnosis
Lost shock diagnosis
It is mainly distinguished from the lymphatic fistula caused by the rupture of the lost window. The latter has frequent fluctuations in hearing and dizziness. The labyrinthine window is broken, the tympanic membrane of the ear examination is normal, occasionally congested and turbid and the liquid level, the rotatory nystagmus is lying on the lower side of the ear, there is an incubation period, accompanied by vertigo, and the fatigue surrounding vestibular type, according to Singleton report, The positional nystagmus has a short latency and is not prone to fatigue. 26% to 60% of the fistula test is positive, and there is a history of head or ear pressure trauma or trauma, or sudden dizziness and deafness after flying, diving and exertion. Those who have a positive fistula test should consider the disease and should be hospitalized for intracranial radiography.
