I fell down and felt dizzy, nauseous and wanted to vomit

If you feel dizzy, nauseous and want to vomit after falling, it is likely that you have a concussion. You must go to the hospital for diagnosis and treatment in time. Concussion patients will initially feel dizzy and nauseous, then gradually have difficulty breathing and even fall into a coma, which may even be life-threatening. At this time, the patient must be admitted to the hospital in time so that the doctor can actively carry out rescue treatment.

1. What is the reason for feeling dizzy, nauseous and vomiting after falling down?

I fell and felt dizzy, nauseous and wanted to vomit. I think there is a high possibility that I had brain concussion.

2. What are the symptoms of concussion?

2.1 Transient brainstem symptoms: Consciousness disturbance occurs immediately after trauma to the head, manifested as confusion or complete coma, lasting for several seconds, minutes or tens of minutes, but generally not more than half an hour. The patient may also experience symptoms such as pale complexion, sweating, decreased blood pressure, slow heartbeat, shallow and slow breathing, decreased muscle tone, and slow or absent various physiological reflexes. In most patients with reversible mild concussion, central nervous system function recovers rapidly from bottom to top, from the cervical spinal cord-medulla oblongata-brainstem to the cerebral cortex.

2.2 Retrograde amnesia (recent amnesia): After the patient regains consciousness, he or she cannot recall the situation at the time of injury or even a period of time before the injury. The more severe the concussion and the longer the primary coma, the more obvious the recent amnesia will be, but the patient can recall past events (remote memory). This may be related to damage to the hippocampus.

2.3. No positive signs were found in neurological examination.

2.4 . Patients in the recovery period of concussion often experience symptoms such as dizziness, headache, nausea, vomiting, tinnitus, insomnia, etc., which usually disappear gradually within weeks to months. However, some patients also have long-term symptoms such as dizziness, headache, insomnia, irritability, inattention and memory loss.

3. Pathogenesis of concussion

3.1 . Animal experiments on concussion found changes in mitochondria, Nissl bodies, and chromosomes in the medulla oblongata, some of which were accompanied by lysosomal membrane rupture.

3.2 . In biochemical studies, the concentrations of acetylcholine and potassium ions in the cerebrospinal fluid of patients with concussion were found to be elevated. The elevated concentrations of these two substances cause conduction blockage in neuronal synapses, thereby making it impossible for the brainstem reticular formation to maintain a person's wakefulness, resulting in impaired consciousness.

3.3 Clinically, half of patients with mild concussion who underwent brainstem auditory evoked potential examinations had organic damage.

3.4. Recently, it is believed that the injury mechanisms of concussion, primary brainstem injury, and diffuse axonal injury are similar, but the degree of injury is different. They are a continuum of different pathological degrees. Some people classify concussion as the mildest type of diffuse axonal injury, but the lesions are limited, the damage is more functional and easy to repair by itself, so the disturbance of consciousness is transient.

How to Treat a Concussion

Concussion does not require special treatment. Generally, only bed rest for 5 to 7 days is required, analgesics and sedatives are given, external stimulation is reduced, a light diet is required, and good explanations are given to eliminate the patient's fear of concussion. Most patients recover to normal within 2 weeks and the prognosis is good.

However, a small number of patients may also develop secondary intracranial lesions or other complications. Therefore, during symptomatic treatment, the patient's mental state, consciousness, clinical symptoms and vital signs must be closely observed, and necessary examinations should be carried out in a timely manner according to the situation. Avoid using morphine-like drugs that may affect observation. It is best to choose analgesics and sedatives with fewer side effects, such as cranioplastin, ibuprofen, naproxen, diazepam, bromide, chlordiazepoxide, and the autonomic nervous system-improving drug oryzanol and the calcium blocker nimodipine.

First aid measures for concussion

The head is easily injured by external force, which may cause concussion, so parents should pay special attention to it. The causes of head injuries vary for children of different ages. Babies aged 3-4 months have just learned to roll over, and if their family members are not careful, they will fall off the bed. Babies aged 6 to 7 months old are very active and may fall to the ground from the hands of adults if they are not careful. When children are learning to walk or have just learned to walk, they often lack self-control when approaching the step at the entrance of the stairs and may roll down. When a child falls and hits his head on the ground, if he hits a hard object such as a concrete floor or a tile floor, he may suffer serious injuries. Parents should be alert to whether this may cause a concussion.

After a collision and injury, there will be immediate temporary loss of consciousness, such as inability to cry and confusion, which will last for about half an hour. Those with minor injuries may only be in a trance (confused), while those with severe injuries may lose consciousness (coma), become irritable, go into mild shock, become pale, or become nauseous and vomit. Some are sleepy and wake up after several hours or overnight. After regaining consciousness, they may still have headaches (children bang their heads with their hands), irritability, vomiting or dizziness. Some may even lose consciousness for a long time. If this kind of phenomenon occurs, it may be a skull fracture, head hematoma, cerebral hemorrhage, etc.