Craniocerebral trauma

Craniocerebral trauma (CCT) is a type of mechanical trauma of a head, at which intracranial contents (brain, meninges, vessels, cranial nerves), skull and in a some cases soft tissues of the head damaged.

CCT is one of the most frequent types of traumas (30-50% of all traumatic damages), is the major cause of death and disability of people before 45 years and occupies the first place in the structure of neurosurgical pathology.

In a war-time the principal reasons of CCT are different gunshot and explosive damages, and in peace-time - its principal reasons are transport, domestic, and indus­trial traumatism. After findings of epidemiological researches, the index of frequency of craniocerebral trauma in economically developed countries achieves on average 4 - 6 per 1000 of population. According to the data of WHO, the amount of cases of craniocerebral trauma increases by 2% annually, that is related to the increase of the amount of transport vehicles, swift urbanization, by not always a sufficient level of the culture of conduct of all participants of traffic.

After inflicting mechanical trauma to the brain, there arises a complicated chain of pathological reactions from the side of all components of the brain and conductive tracts which are contained in the concept of "traumatic illness of the brain"("wound dystrophy of the brain"). Notably, for the trauma of the brain characteristic is a disorder of consciousness as a display of a disturbance of connection between neurons. Any CCT results in disorders of hemodynamics of the brain, that is one of the principal reasons of the development of the so-called remote consequences of CCT. Its normalization takes sometimes many months and even years.

These disorders can aggravate mechanical damages of nervous tissue. Disorders of blood flow conduce to the secondary necrosis around the primary one (due to contusion of the brain) and require intensive treatment for its prevention.

Craniocerebral trauma is characterized by the primary (related to the immediate damage of the corresponding centres of the central nervous system) and secondary (conditioned by peculiarities of the clinical course of CCT) dysfunctions of internals. The most significant of them are respiratory dysfunctions. The stream of pathological impulses to the lungs in severe trauma of the brain causes disorder of hemocirculation in them, that often leads to the emerging of pneumonia with the early beginning and persistent progressing course in patients. Patients with severe forms of CCT develop apparent disorders of metabolism, one sometimes observes gastroenteric hemorrhages, perforated gastric and intestine ulcers and other threatening complications.

Date: 2015-01-02; view: 1689