Patient's question:
The child began showing symptoms in early August this year, crying and fussing (suspected abdominal cramps), low-grade fever with diarrhea, cough with nasal discharge, poor sleep and appetite. Treatment for cold/intestinal issues showed fluctuating improvement. The child exhibits head scratching and arched back posture, but no high fever, convulsions, or muscle spasms. The child is alert and intelligent, but when severely affected, cannot hold their head upright and vomits when eating.Doctor's answer:
1. Medical Consultation: Inquire about the time of injury, the type of injury-causing object, whether cerebrospinal fluid or brain tissue is leaking from the wound, and the treatment received.2. Head Wound Examination: Carefully inspect the wound size, shape, presence of active bleeding, presence of bone fragments, or leakage of cerebrospinal fluid or brain tissue. If cerebrospinal fluid or brain tissue is leaking from the wound, it is diagnosed as an open cranial brain injury.
3. Consciousness Disturbance: It depends on the location and severity of brain injury. Localized open injuries that do not affect important brain structures or patients without intracranial hypertension typically do not cause consciousness disturbances. However, widespread brain injuries, such as those affecting the brainstem or hypothalamus, combined with intracranial hematoma or cerebral edema leading to intracranial hypertension, may result in varying degrees of consciousness disturbances.
4. Focal Symptoms: Depending on the location of brain injury, symptoms such as hemiplegia, aphasia, epilepsy, contralateral hemianopia, and sensory deficits may occur.
5. Intracranial Hypertension Symptoms: Small wounds, hematoma within the wound tract or (and) combined with intracranial hematoma, as well as severe intracranial pressure elevation caused by widespread contusions and lacerations, may lead to symptoms such as headache, vomiting, progressive consciousness disturbances, or even herniation of the brain.
6. Skull X-ray: To determine the location, type, displacement, and position of intracranial metallic foreign bodies or embedded objects of the skull fracture.
7. Head CT Scan: Can diagnose intracranial hematoma, contusions and lacerations, subarachnoid hemorrhage, midline shift, size and shape of ventricles, intracranial foreign bodies, and skull fractures, but may not show as completely as X-ray images. It has significant reference value.
8. Lumbar Puncture: Helps assess the presence of intracranial infection and intracranial pressure.
9. Electroencephalography: Helps diagnose traumatic epilepsy.