Gorodnyk G. Pathogenesis of brain oedema and swelling and substantiation of optimal pharmacotherapy at the serious craniocerebral trauma (clinical and experimental research)

The object of the research deals with peculiarities of the development of oedema and swelling of brain white and grey substances under the serious craniocerebral trauma (CCT), its diagnostics and effectiveness of pharmacological cures and intensive therapy; the aim is to clarify peculiarities of pathogenesis of brain oedema and swelling (BOS) in the dynamics of initial period of traumatic disease and on the basis of diagnostic methods improving to elaborate prognosis of trauma consequence, cerebral death, and also to prove some new approaches to the effective intensive therapy of the injured with serious CCT; experimental, clinical, morphological, biochemical, immune and enzyme, instrumental, functional and statistic methods, new aspects of the research and its results - the concept of BOS as pathological process appearing under a serious CCT got further development; it's shown that BOS may be localized with equal frequency in white, grey, white and grey brain substances; irreversible brain changes shown up as primary and secondary dystrophies and neurotic necrosis, oedematic nervous fabric making light, cites' swelling are determined by the expressed BOS, brain circulation of blood violation which appear in the first two days of sharp period; there were also new elaborated criteria and kinds of the early non-invasive estimation of the expression of selective brain white and grey substances oedema and swelling, prognosis of trauma outcome and cerebral death; the research new aspects may also be characterized with information concerning to frequency of distribution and expression of the process of brain oedema and swelling under CCT in different brain topic structures, and also with proving the data for appointment of different therapeutic measures; new is the concept of intensive therapy protocols balancing by separate pharmacological preparations; implemented to medical and diagnostic process of the Institute of traumatology and orthopaedy under Donetsk National Medical University, the Institute of urgent and restoration surgery under the name of V.K. Gusak of NAMS of Ukraine, regional traumatology hospital, Donetsk regional clinical territory medical union, departments of reanimation, intensive therapy, computer tomography, neuro-surgery, neuro-traumatology of hospitals in Donetsk City, Makeevka City, Enakievo City, Dnepropetrovsk City, and also to teaching process of Donetsk, Ivano-Frankovsk, Lvov, Zaporozh'e, Ternopol, Bukovina medical universities and Dnepropetrovsk medical Academy; field of using - scientific and teaching process of general theoretic and clinical departments in medical universities (pathological physiology, anesthesiology, reanimatology, neurosurgery), and also medical and diagnostic process of reanimation, neurosurgery and traumatology departments.