Semchyshyn M. Clinical and pathogenetic features of the course of traumatic brain injury of varying severity in victims of peaceful territory and in fighters of the joint forces operation (OJF-ATO)

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0521U101995

Applicant for

Specialization

  • 14.01.15 - Нервові хвороби

21-09-2021

Specialized Academic Board

Д 64.566.01

State institution "Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine"

Essay

The dissertation presents a theoretical generalization and a new solution to a topical scientific problem, which is to study the clinical and pathogenetic mechanisms of peaceful and combat trauma of brain injury of mild and moderate severity. Based on clinical-neurological, instrumental, psychopathological, laboratory and statistical research methods, compared features of course of traumatic brain injury of mild and moderate severity in acute, intermediate and remote periods in victims of peaceful territory and in fighters of the joint forces operation (OJF-ATO), and in particular, in determining the role of trace elements homeostasis, as one of the links in the pathogenesis of this pathology. Proved that combat trauma of brain injury is an injury with a more severe and prolonged course, and, accordingly the consequences, in contrast to peaceful trauma of brain injury. The intensity, frequency of complaints and the range of neurological disorders depend on the severity of the brain injury and the conditions and place of receipt. It is confirmed that the peculiarity of combat trauma of brain injury is that the victim was in a state of stress before the brain injury, which affects and aggravates the traumatic process. Found that cognitive impairment in different periods of the brain injury prevailed in the group of fighters of the joint forces operation (OJF-ATO), which gave reason to think about the possibility of their further development of traumatic brain disease. The factor that influenced the severity of cognitive impairment in trauma of brain injury in fighters of the joint forces operation (OJF-ATO) was stress. The pathogenesis significance of mineral homeostasis for determining the clinical form and predicting the duration of the acute period of trauma brain injury of varying severity in victims of peaceful territory and in fighters of the joint forces operation (OJF-ATO) is substantiated. The presence of significant more frequent and stronger correlations between the levels of micronutrients in groups of fighters of the joint forces operation (OJF-ATO) has been proved, compared with the victims of peaceful territory, and the factors that, when combined, affect the clinical form and duration of the acute period of trauma brain injury (to its reduction in the group of victims of peaceful territory led to a significant increase in levels Fe, Zn, Cr (р<0,05), and in the group of fighters of the joint forces operation (OJF-ATO) a significant increase in levels Zn, Cr, Se and I (р<0,05)). The algorithm of actions in the program "Excel" for calculation of duration of the acute period and a clinical form of a trauma brain injury is offered. The effectiveness of cytoflavin and entropy, which had a positive effect on the regression of complaints, neurological symptoms, cognitive impairment, the dynamics of changes in the EEG, mineral homeostasis, the frequency of post-traumatic syndromes, and also contributed to the correction of cerebral circulatory disorders to the trauma brain injury with mild and moderate severity in victims of peaceful territory and in fighters of the joint forces operation (OJF-ATO).

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