Craniocerebral trauma: treatment

Craniocerebral injury( TBI) can be of different severity. Treatment of such an injury should begin immediately after it is received. First aid and resuscitation should begin immediately when doctors arrive at the prehospital stage. After, depending on the type of injury, already in the medical institution is assigned this or that treatment of craniocerebral trauma.

Resuscitation measures with craniocerebral trauma

They are aimed at maintaining impaired vital functions, preventing ischemia, as well as hypoxia of the brain due to blood loss, airway obstruction, severe hemodynamic disorders. To ensure adequate gas exchange the airways are released, the airway is inserted, trachea intubation or tracheostomy is performed, inhalation of the oxygen-air mixture is performed. In motor or psychomotor agitation, sedatives are used. With CTBT, urgent surgery is often crucial. Already in the hospital, measures are continuing to normalize hemodynamics, metabolic processes, gas exchange, various methods of prevention, as well as treatment of cerebral edema, cerebral circulation disorders, intracranial hypertension, liquor circulation and metabolism, use means and methods to protect the brain from hypoxia and ischemia. Also conducted are: general anesthesia, central hemodynamic management, correction of KHS and water-electrolyte metabolism, coping of cerebral edema, intracranial hypertension, etc.

Craniocerebral trauma - conservative treatment

Intensity, duration and volume of conservative treatment( CR), as a rule, Are determined by the type and severity of TBI, the severity of intracranial hypertension, cerebral edema, microcirculation and liquorotox disorders, as well as the presence of trauma complications, age and features of the premorbid statesuffered. To select the tactic of CL, the evaluation of the clinical form of the injury is of particular importance, which determines the severity of the condition of the patients and the substrate of damage.

With concussion of the brain, treatment is aimed at removing excessive cerebral reactions, restoring the functional activity of the most prone microdeformations of brain stem structures. The main directions of concussion treatment are: adherence to bed rest, use of sedative, hyposensitizing and vegetotrophic drugs.

In order to stabilize cerebral microcirculation in pronounced vegetative reactions intravenously injected with euphyllin. In the acute period, the use of dehydrating agents, in particular, saluretics( ethacrynic acid, furosemide) with correction of potassium deficiency( panangin, diet) is justified. In case of sleep disorders, phenobarbital and diazepam are added to sedatives. With persisting asthenia, caffeine and other stimulants are usually used. In the future, for the prevention of residual post-traumatic phenomena, pyriditol, nootropol and other nootropics are prescribed.

Craniocerebral trauma - surgical treatment of

In most cases, the purpose of surgery for CCT is to remove the dislocation of the trunk, compression of the brain. Operative treatment of CCT is performed with compression of the brain by subdural, intracerebral, epidural, traumatic hygromas, hematomas. Some forms of bruising are brain crushing, with wounds of venous sinuses, dented cranial fractures, posttraumatic carotid-cavernous and other vascular joints, wounds, venous sinuses, foreign bodies of the skull, in the presence of trephine holes, chronic and acute posttraumatic hydrocephalus, scars, cysts, Gunshot wounds to the skull, also to the brain, some forms of epilepsy, etc.

The main principle of surgical intervention for acute trauma, especially with intracranial hematomasIs the speed of the operation. The sooner the operation is done from the moment of injury, the more likely the patient's survival and rehabilitation will be. Therefore, the victim is operated immediately after the diagnosis is established, without additional research.

Treatment of a combination of CMT involves conditionally three main links. It is the fight against violations( threatening) of vital functions;This treatment of local extracranial and cranial lesions, as well as the prevention of complications. Socio-labor and medical rehabilitation of patients with a primary focus on impaired functions.