RESUMEN
Peculiarities of clinical course of intracerebral hematoma (ICH) in isolated cranio-cerebral trauma (CCT), and factors, influencing the surgical treatment results, were analyzed. Medical histories of 188 injured persons, suffering isolated CCT, were analyzed, in 14 of them ICH was revealed. In isolated CCT the brain contusion focus, revealed in first hours after trauma, in accordance to CT of the brain data, during 10 - 12 h may be transformed into ICH, with increase of the brain oedema severity, what constitutes bad prognostic sign. There are following unfavorable factors: severe state of the injured person while his admittance to hospital, decompensation of the CCT course, elderly age, absence of treatment on prehospital stage, the operation performance later than in 1 - 2 h after admittance to hospital, occurrence of cerebral and extracerebral complications postoperatively, including focus of encephalomalacia, meningoencephalitis, and pulmonary complications as well.
Asunto(s)
Hemorragia Intracraneal Traumática/cirugía , Anciano , Edema Encefálico/diagnóstico por imagen , Edema Encefálico/etiología , Traumatismos Craneocerebrales/complicaciones , Traumatismos Craneocerebrales/diagnóstico por imagen , Traumatismos Craneocerebrales/mortalidad , Traumatismos Craneocerebrales/cirugía , Humanos , Hemorragia Intracraneal Traumática/diagnóstico por imagen , Hemorragia Intracraneal Traumática/etiología , Hemorragia Intracraneal Traumática/mortalidad , Registros Médicos , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Factores Sexuales , Factores de Tiempo , Tomografía Computarizada por Rayos X , Índices de Gravedad del Trauma , Resultado del TratamientoRESUMEN
An analysis of 463 patients operated upon for severe cranio-cerebral traumas has shown that one of the main factors improving results of treatment is using the methods of neurosurgical prophylactics of intracranial hemorrhages in the postoperative period. A considerably less incidence of intracranial hemorrhages can be achieved by using the inflow-outflow dialysis system, removing the crushed brain substance, suturing the dura mater to the periosteum at the borders of the bone defect. The ends of the ligature are taken out onto the skin through the holes in the center of the osseous flap.
Asunto(s)
Lesiones Encefálicas/complicaciones , Hemorragia Cerebral/prevención & control , Complicaciones Posoperatorias/prevención & control , Fracturas Craneales/complicaciones , Lesiones Encefálicas/cirugía , Hemorragia Cerebral/etiología , Drenaje , Humanos , Cuidados Intraoperatorios , Complicaciones Posoperatorias/etiología , Fracturas Craneales/cirugía , Irrigación TerapéuticaRESUMEN
Timely application of adequate diagnostic and therapeutic measures, reoperations among others, allows mortality to be reduced to 33% in postoperative epidural hematomas, to 50% in recurrent intracranial hematomas, and by 19% in edema and swelling of the brain with its compression. Methods of neurosurgical prevention of complications, the use of an inflow-outflow dialysis system and removal of crushed brain areas attendant to the hematomas in the first place, are the leading factor in improving the outcomes of the treatment of acute traumatic intracranial hematomas.