Lytvynenko A. The prognostic criteria of traumatic intracranial hematomas surgical treatment in the acute period of a craniocereberal trauma

The dissertation is devoted to the improvement of treatment results of patients with traumatic intracranial hematomas in the acute period of craniocereberal trauma on the basis of prognostic criteria definition of and their introduction in medical tactics.The following criteria are significant for the forecast: consciousness infringement - 8 points and less according to Glasgow Coma Scale, alcoholic intoxication at the moment of trauma, displacement of median structures over 1 sm, the volume of hematomas over 100 sm3, removal of hematomas after 3 hours and later from the moment of clinical manifestation. The most essential criteria (which led to death of 77,8-100% patients) are ventricular hemorrhage, arterial hypotension, holding of intracranial pressure at 15 mm Hg and higher in spite of it's correction, nosocomial pneumonia.In case of 5 and more prognostic criteria simultaneous definition, the death rate was 100%, in case of 4 - 76,9%.The tactics of patients' treatment have to be based on the accurate algorithm of the actions, that accounts kind and quantity of prognostic criteria.