Let's try to find out what constitutes a concussion. The severity of harm to health is fixed by a special commission - forensic experts.
In 1982, a classification of this type of injury was developed. Three forms are distinguished:
- bruises of varying severity;
- concussion of any form;
- squeezing
Varieties
There are two types of head injuries; closed and open. What is CCST? What harm do such injuries do? Closed craniocerebral trauma involves fractures of the bones of the skull that do not cause damage to the skin.
TBI is considered open if there is a wound, therefore, skin is damaged in the region of the cerebral region of the skull.
If the dura mater is intact, the traumatic brain injury is non-penetrating, otherwise penetrating.
Recommendations to experts on assessment activities
Consider an algorithm for assessing the severity of harm to health during concussion, as well as in other TBIs. What you need to know in order to properly assess the patient’s health status?
Assume that a brain concussion occurred in a patient as a result of an accident. What is the severity of health? Assessment of harm caused by TBI is complex and commission based. An expert group is being created, which includes a neurosurgeon, a neuropathologist. With psychopathological manifestations of trauma, a psychiatrist is involved in the examination committee for examination.
If the patient has a concussion, the severity of the damage to health is determined precisely by the expert group of medical workers. Problems with neurons in brain injury are due to damage to the temporal and frontal lobes of the brain, damage to the white matter of the cerebral hemispheres.
Document Requirements
Medical documents that are presented for analysis by experts suggest complete data, without which it is difficult to resolve issues. For example, the medical history contains daily records showing the dynamics of the patient's condition.
If experts cannot determine the severity of the injury is a concussion, they have doubts, in this case a second examination of the patient is carried out, additional specialists are introduced to the commission.
Examination without a full examination of the victim, carried out according to the originals of medical documents (outpatient records, medical history), is allowed only when it is completely impossible for a real examination of the patient by experts.
Exceptional cases in which concussion is determined in absentia, the severity of harm to health, are possible only with the provision of special medical documents that contain comprehensive information about all injuries, as well as the clinical course and outcome.
The records should also contain other information that the experts will need to resolve the issues posed to them.
Important points
If the patient has a concussion, the severity of the damage to health is detected by decision of the commission conducting a forensic medical assessment of the patient's condition. It is based on objective injuries that were found in the victim as part of his examination in a medical organization.
Assessing the consequences of a traumatic brain injury involves identifying and accounting for the consequences of an exacerbation or complications that preceded the injury.Also analyzed are violations of medical care that could affect the patient’s state of health.
Additional actions
If there is a need to distinguish (establish) the genesis of the found TBI problem and symptoms, the long-term consequences of other similar injuries or central nervous system diseases, in addition to a comprehensive differentiated diagnosis of the criminal case materials, as well as the results of the examination of the victim by experts, it is necessary to evaluate:
- a complex of clinical and morphological manifestations of head injury with an assessment of the location and direction of the traumatic effect;
- ergometric parameters of traumatic actions that are interpreted as a manifestation of the analyzed TBI.
If it is not possible to make these distinctions, this is necessarily reflected in the expert opinion.
Assessment Algorithm
How to evaluate concussion? What degree of severity of health damage is caused by the actions of another person? There is a special algorithm that determines the severity of health as a result of a head injury. A priority criterion is the danger to the life of the victim.
Among the manifestations that cause the danger, several forms and types are distinguished.
The first group includes:
- brain contusion of moderate and severe degree, head injury with penetration into the cranial cavity;
- fractures of the base and fornix of the skull open and closed.
The next part is the consequences of TBI in the form of diseases or pathological conditions that threaten a person’s life:
- cerebral coma;
- significant blood loss;
- traumatic shock of the III-IV degree;
- purulent-septic state;
- organ and regional circulatory disorders that contributed to cerebral infarction.
The consequences of a head injury that are not life threatening but cause serious health damage are caused by a mental disorder, the diagnosis of which is carried out during a forensic psychiatric examination.
Long-term loss of normal working capacity by at least thirty percent that arose due to the numerous residual effects of a severe head injury is recognized as a serious problem. It is accompanied by dementia, epileptic seizures, speech disorders, loss of coordination of movements, decreased muscle tone, and weakened memory.
Also among the serious health consequences for TBI are recognized the consequences of damage to the bones of the base and fornix of the skull, brain contusion, including the presence of a trepanation defect.
Moderate severity parameters
The criteria of this group include a long-term health disorder, the result of which was a head injury (for more than 21 days). Also included here are disability up to 30% for a period of more than 120 days, a slight loss of coordination, problems with smell, the presence of a trepanation defect up to 10 cm in size.
Light weight to health
To what degree of severity does concussion legally apply? If the health disorder did not exceed 21 days, in this case, experts note in the conclusion that the injured person is slightly injured in health.
When assessing the severity of a person’s health in case of a brain injury, concussion, temporary disability is considered the main criterion (the duration of a full health disorder).
Estimated deadlines for disability in injuries and diseases have been developed. For example, with severe traumatic brain injuries, the patient loses his ability to work for a period of 80 to 100 days, and with a mild concussion for up to 22 days.
To summarize some of the results.
In some cases, with a concussion, the severity of the damage to health is due to the appearance of autonomic dysfunction, as well as the development of hydrocephalus. As the long-term consequences of a concussion of a mild form, medical workers consider the development of epileptiform seizures.The reason for such phenomena may be untimely hospitalization, the presence of somatic diseases, defective pathogenetic treatment.
According to the rules, the severity of harm to health is not determined in cases of head injury, if the victim was unreliably made the initial diagnosis, if the outcome of the injury is not clear, full laboratory and clinical studies have not been conducted.
The relevance of the issue of determining the severity of various types of damage, including concussion in road accidents, is explained by an increase in the number of citizens seeking medical help. Traumatic brain injuries have become the most common problems, these diseases are leading in referring to the emergency rooms of hospitals, to primary care centers.
According to the results of statistical studies, most often fatal head injuries occur to people aged twenty to thirty years. In more than half of the total number of CCIs, physicians fix a concussion, which is considered the easiest type of brain damage.
Concussion occurs not only with head bruises during an accident. It is also possible when falling on the back, on the buttocks, due to a hit on a hard surface when jumping.
When establishing the damage that was caused to the health of the victim, which is important, for example, in the presence of a criminal or administrative case, a special medical commission is created, which includes a neurosurgeon, psychiatrist, neurologist, surgeon. If the injury was sustained at the workplace when a person performed his official duties, in this case, according to the decision of the ITU Bureau, a disability group may be assigned to the victim, a social allowance will be assigned, the amount of which depends on the degree of health loss determined by experts.