Complications of craniocerebral trauma

Many patients who survived a severe craniocerebral trauma remain invalids because of psychical disorders, decrease of memory, disturbances of motions, speech, posttraumatic epilepsy and for other reasons.

Complications of craniocerebral trauma are various enough, their nature in a great deal depends on the type of craniocerebral trauma, and they can be convention­ally divided into the following groups:

I. Pyoinflammatory craniocerebral:

- suppuration of the soft tissues of the skull;

- meningitis;

- encephalitis (meningoencephalitis);

- encephalopyosis (early and late);

- ventriculitis;

- posttraumatic empyema (epi- or subdural);

- thromboses of the sinuses and thromboses of intracranial veins;

- posttraumatic granulomas;

- late prolapse of the brain.

II. Noninflammatory craniocerebral:

- early prolapse of the brain;

- early episyndrome and epileptic state;

- dislocation syndromes;

- nonsuppurative thromboses of venous sinuses;

- thromboembolia of vessels of the brain, infarction of the brain;

- collapse of the brain ;

- liquorrhea.

III. Extracranial complications:

- shock;

- DIC-syndrome;

- pneumonia;

- gastroenteric bleeding;

- acute cardiovascular collapse, disturbances of cardiac rhythm;

Consequences of CCT are also varied enough, at the basis of which there can be atrophic processes in the brain, inflammatory changes in its membrains, disorders of liquorocirculation and blood flow, and some others.

Consequences of CCT:

• posttraumatic arachnoiditis (adhesive, cystophorous, adhesive- cysto- phorous; diffuse, convexital, basal, subtentorial, focal, "spotted", optochi- asmal);

• hydrocephaly;

• pneumocephaly;

• porencephaly;

• defects of the skull;

• deformation of the skull;

• liquor fistula;

• damages of cranial nerves, as well as central paresises and paralyses;

• tucaniry-cerebral cicatrices;

• atrophy of the brain (diffuse, local);

• cysts (subarachnoid, intracranial);

• epilepsy;

• carotid-cavernous anastomosis;

• ischemic damages of the brain;

• arterial aneurysms of the vessels of the brain;

• parkinsonism;

• psychical and vegetative dysfunctions.

Complications as amnesia, decline of capacity for work, persistent headache, vegetative and endocrine disorders can be observed in a large number of patients survived craniocerebral trauma of a mild and moderate degree of severity.

Some complications and consequences of craniocerebral damages require surgical treatment: posttraumatic suppurative complications (abscesses, empyemas), aresorptive hydrocephaly, carotid-cavernous anastomoses, posttraumatic defects of the skull and some others.

Date: 2015-01-02; view: 1253