Differentiated treatment of acute diffuse brain injuries

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Diagnosis and treatment results of 57 patients with acute diffuse brain injury have been analyzed. Patients were divided into two groups: first study period 2000-2005; second study period 2006-2010. The main differences between the first and the second study periods were in health condition and brain functions monitoring parameters, therapy approaches and goals. Increasing of axial and lateral dislocation symptoms during progression from the first type of diffuse injury to the fourth one is related to intracranial hypertension (ICH) occurrence rate and significance it's significance. During the second study period, ICH was found in 25% patients with the second type of injury, 57% patients with the third type of injury, and 80%, with the fourth type of injury. Mean ICP in the group of patients with the second type of diffuse injury comprised 14.4±6.6 mmHg; with the third type of injuty, 30±20.6 mmHg; with the fourth type of injuty, 37.6±14.1 mmHg. Introduction of differentiated approach to conservative or surgical treatment method application to acute diffuse brain injuries patients based on ICP monitoring data led to 13.8% reduction in mortality in the second study period compared with the first study period.

Keywords:

acute traumatic brain injury

diffuse brain injuriy

differentiated treatment

intracranial pressure

intracranial hypertension

decompressive craniectomy

Authors:

Pedachenko E.G.

GU "Institut neĭrokhirurgii im. akad. A.P. Romodanova NAMN Ukrainy", Kiev

Dziak L.A.

GU "Dnepropetrovskaia meditsinskaia akademiia Minzdrava Ukrainy"

Sirko A.G.

GU "Dnepropetrovskaia meditsinskaia akademiia Minzdrava Ukrainy"

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