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Modern principles in the treatment of brain contusions

DOI: https://doi.org/10.29296/25877305-2020-12-04
Issue: 
12
Year: 
2020

A. Yarikov(1)–3, Candidate of Medical Sciences; P. Smirnov(2), Candidate of Medical Sciences;
Professor A. Fraerman(2), MD; V. Leonov(2); V. Khakhin(3) (1)City Clinical Hospital Thirteenth, Nizhny
Novgorod (2)City Clinical Hospital Thirty-Nine, Nizhny Novgorod (3)Volga District Medical Center, Federal
Biomedical Agency, Nizhny Novgorod

Craniocerebral traumas (CCT) account for 40% in the pattern of traumatic injuries. Brain damage is the leading cause of death and disability in the populations under 40 years of age. According to the clinical classification of brain contusions (BC) in Russia, which evaluates the clinical course of CCT and neurological status, they are divided into mild, moderate and severe types. The authors also identify an anatomical classification, such as foci of local posttraumatic ischemia or those of type I contusion, foci of contusion or those of type II contusion, intracerebral hematomas or foci of type III contusion. In the clinical course of BC, one type of contusion turns into another, i.e. its development is a dynamic process. An increase in the BC focus over time is called its progression, while 35-50% of hemorrhagic foci are prone to develop. The paper describes predictors for the progression of contusion foci and also considers in detail the treatment of BC, namely medical and surgical treatments. Neuroprotection occupies a special place in the treatment of BC.

Keywords: 
traumatology
neurology
brain contusion
neuroprotection
decompressive craniotomy
secondary injury
evolution of a brain contusion focus



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