Novak A. Optimization of diagnostic and therapeutic measures in patients with mild traumatic brain injury

The dissertation research provides a theoretical generalization and a new solution to an urgent scientific problem - optimization of the diagnostic and therapeutic tactics for persons who have undergone mild traumatic brain injury based on an in-depth study of the clinical course, psychodiagnostic parameters, assessment of neuroplasticity (the state of neurotrophic factors and factors of apoptosis) in blood serum and quality of life. The study is based on the results of complex clinical neurological, psychodiagnostic, instrumental and biochemical studies of 100 patients with the consequences of mild traumatic brain injury (MTBI) 1-5 years after receiving acute MTBI. On the basis of a systematic approach, the author for the first time expanded ideas for a comprehensive assessment of the significance and established the nature of the relationship between the clinical-neurological, psychodiagnostic and neurophysiological characteristics of the condition of patients who underwent TBI, depending on the duration of the injury. The understanding of the peculiarities of the formation of clinical manifestations of traumatic encephalopathy was deepened, a comprehensive assessment of the significance was carried out, and the nature of the relationship between clinical neurological, psychometric and neurophysiological characteristics in patients with different MTBI catamnesis was established. The necessity of determining neurocognitive impairments, assessing the psychoemotional status, which affect the quality of life of patients in the first 5 years after receiving MTBI, is shown. The content was studied and the relationship of the revealed changes in the content of neurotrophic factors (BDNF, beta-NGF) and apoptosis factors (proteins of the Bacl subfamily) was analyzed. On the basis of a comprehensive analysis of clinical and paraclinical parameters, treatment regimens for this category of patients were optimized, where a drug with a neurotrophic effect Cerebrolysin can be used as the base therapeutic agent, and nootropic drugs Entrop or Cognifen can be prescribed to patients with psychoemotional disorders.