Head trauma is caused by external injury, characterized by symptoms such as loss of consciousness, agitation, dizziness, headache, nausea, and vomiting.This condition corresponds to what Western medicine refers to as intracranial hematoma and concussion.【Diagnostic Criteria】1. A history of head trauma or indirect injury. Symptoms may develop within hours after a violent impact to the head or may appear up to three weeks post-injury.2. Post-injury, there may be loss of consciousness, which can manifest as a cycle of coma—improvement or awakening—followed by a return to coma; alternatively, there may be no initial coma, with gradual onset later; or persistent coma that worsens over time.3. Symptoms may include agitation, headache, dizziness, nausea, vomiting, recent memory loss, hemiplegia, and changes in pupil size.4. Respiratory patterns may show deep and slow breathing, with a pulse that initially increases and then decreases in blood pressure. In severe cases, breathing may stop, leading to cardiac arrest.5. X-rays of the skull may reveal fractures, while CT scans of the head can show localized high-density areas indicating hematoma and help determine the location and extent of the injury.【Differential Diagnosis】Hemorrhagic stroke: Often presents with snoring and a history of vertigo without any head injury.【Pattern Differentiation and Treatment】1. Qi Stagnation and Spirit Obstruction: Coma following head injury, pale complexion, soft limbs, irregular breathing, changes in pupil size, incontinence, and a weak or wiry pulse. Treatment involves moving Qi and opening the orifices. Use Wumo Decoction combined with Suhexiang Pill.2. Blood Stasis Obstructing the Brain: Following head trauma, symptoms include headache, vomiting, altered consciousness, agitation, or paralysis, with a dark purple tongue and a wiry, weak, yet forceful pulse. Treatment focuses on resolving stasis and promoting circulation. Modify Tongqiao Huoxue Decoction.3. Blood Stasis with Heat: Post-injury, there may be altered consciousness, agitation, fever, vomiting, headache, or paralysis, with a dark red tongue, yellow coating, and a wiry, rapid pulse. Treatment aims to clear heat, resolve stasis, and open the channels. Modify Taohong Siwu Decoction.4. Yang Collapse: Coma following head injury, pale complexion, cold limbs, profuse sweating, incontinence, open mouth, weak breath, dilated pupils, and a faint pulse. Treatment involves restoring Yang and stabilizing collapse. Use Shenfu Decoction.【Other Treatments】1. Patients with frequent vomiting or coma should avoid food. Intravenous fluids should be administered to maintain electrolyte balance, with close monitoring of changes in condition.2. Acupuncture therapy:(1) Body acupuncture: For comatose patients, needle points such as Ren Zhong, Shi Xuan, and Yong Quan. For those with vomiting, needle points like Nei Guan, Zu San Li, and Tian Tu.(2) Ear acupuncture: Points such as Cortical Sub, Shen Men, Heart-Kidney, and Sympathetic can be used.3. Single herbal formulas:(1) Intracranial Stasis Decoction: Musk 0.06g, Chuanxiong 6g, Xue Jie 6g, Danshen 15g, Chi Shao 10g, Taoren 10g, Honghua 10g, Ruxiang 9g, Shanzhen 9g, E Zhu 9g, Xiangfu 10g, Dibeichong 9g. Except for Musk and Xue Jie, which should be taken separately, the other herbs should be decocted together.(2) Sanqi 10g, Tianma 10g, Quanxie 3g, decocted in water.4. Western medicine: Main methods include dehydration and surgical treatment. Dehydration can be achieved using Mannitol, hypertonic saline, furosemide, or corticosteroids. Surgical options include craniotomy, burr hole exploration, and intracranial hematoma evacuation.
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