Features of the patient management with traumatic brain injury

Author:

M.L. CHUKHLOVINA1, A.A. CHUKHLOVIN2

1Almazov National Medical Research Center, Ministry of Healthcare, St. Petersburg, Russia

2Polenov Russian Research Neurosurgical Institute — Branch Almazov National Medical Research Center, St. Petersburg, Russia

Summary:
The aim of our study was to consider features of pathogenesis, diagnosis and therapy of traumatic brain injury (TBI) from the viewpoint of neurologist. The mechanisms of emerging injury of the central nervous system, including neuro-inflammation and oxidative stress in patients with TBI, and correlations between clinical manifestations and severity of TBI are discussed. Special attention is paid to the description of certain TBI consequences, e.g. structural drug-resistant epilepsy and post-traumatic stress disorder. We provide evidence for difficulties and lesser availability of rehabilitation programs to patients with TBI during COVID-19 pandemics. One should mention a need for administration of Mexidol as the antioxidant/antihypoxant drug into complex therapy of TBI in such patients. In the period of COVID-19 pandemics, the role of neurologist in management of TBI patients still increases, especially, at the outpatient treatment stage, and when carrying out therapy and medical rehabilitation programs. Keywords: traumatic brain injury, oxidative stress, structural drug-resistant epilepsy, posttraumatic stress disorder, SARS-CoV-2 infection, Mexidol.


Neuroprotection of cerebral accidents in ambulance phase

Author:
V. L. RADUSHKEVICH, A. I. OKUNEVSKY
Voronezh State Medical University n. a. N. N. Burdenko, Voronezh, Russia

Summary:
Relevance. Neuroprotection is a required component of intensive therapy of cerebral catastrophes on pre-hospital and hospital phases of care. The purpose of the study. Identification features and the effect of neuroprotection of different cerebral accidents. Materials and methods. For determination the level of knowledge and practical skills of neuroprotection of different cerebral accidents were conduct an anonymous voluntary questioning doctors Voronezh city ambulance station. The effectiveness of the use of neuroprotection of cerebral accidents was study by special protocols in practice on Voronezh ambulance station. The results. More good theoretical training believe 75 % doctors. Using mexidolum in complex intensive therapy on the prehospital neuroprotection of cerebral accidents has expressed a positive clinical effect.

Keywords: cerebral accident, neuroprotection, ambulance.


Oxidative stress and its pharmacological correction mexidol in traumatic brain injury

Author:
N.V. GOVOROVA
State budget institution of higher professional education «Omsk State Medical Academy» of Ministry for health care of Russia, Omsk, Russia

Summary:
Abstract. Examined and treated 114 patients with isolated severe head injury at the age of 18 to 55 years. Group I included 61 patients who survived, in group II — 53 patients who died on the 3–15th day post-traumatic period. Patients I and II groups had complex intensive therapy according to existing protocols. 15 patients (subgroup I1) was prepared in the complex therapy meksidol 1200 mg per day for 7–10 days. Against the background of mexidol decreased intensity of lipid peroxidation, maintained at a sufficient level power antioxidant defense system cells, there was an earlier resolution of post-traumatic encephalopathy and recovery of consciousness. The treatment mexidol noted more favorable during the early post-traumatic period, a reduction of complications (χ2=55,4; p<0,0001) — syndrome of acute lung injury, disseminated intravascular coagulation, acute cardiovascular failure, and pneumonia.

Keywords: traumatic brain injury, oxidative stress, mexidol.


Contemporary aspects of diagnostics and treatment of post-traumatic stress disorder in patients with brain injury

Author:
M.L. CHUKHLOVINA
State Pediatric Medical Academy, St. Petersburg

Summary:
Abstract. Thirty four patients (14 females and 20 males, 18 to 44 years old) with a post-traumatic stress disorder (PTSD) after mild brain injury were under observation. To perform scoring of cognitive functions and severity of anxious state, appropriate specific scales - Mini-Mental State examination – MMSE and Covi anxiety scale were employed. Levels of patients’ recovery motivation for their own disease were assessed with a special questionnaire (Recovery Locus of Control). Cognitive functions were decreased, showing mild to moderate disorders in patients with PTSD after brain injury. The levels of motivation for recovery from own disorder proved to be significantly decreased, and an inverse correlation was found between this parameter, and a degree of anxious condition in these patients. Treatment of the patients with Mexidolum improved cognitive functions, motivation, decreased the degree of anxious condition in PTSD. The results of study argue for a necessity of early detection PTSD after mild brain injury and inclusion of modern antioxidant and antianxiety drugs into combined therapy of the disease.

Keywords: post-traumatic stress disorder, brain injury, cognitive functions, anxious condition, Mexidolum.