International Medical Journal, Vol. 24., Iss. 3, 2018, P. 50−54.
CHARACTERISTICS OF NEUROIMAGING FINDINGS IN PATIENTS WITH POST-TRAUMATIC CONSCIOUSNESS DISORDERS
Research and Practice Centre of Neurorehabilitation "Nodus", Brovary, Kyiv Region, Ukraine
Owing to the success of modern critical care medicine, the number of patients surviving after severe craniocerebral trauma increases annually. But the emerging post−traumatic disorders of consciousness without adequate early rehabilitation terminate lethally. Therefore, it is necessary to search for diagnostic criteria based on the severity of organic lesions of the brain substance according to X−ray computed tomography, which allows predicting patients recovery from coma after severe craniocerebral trauma. To determine informativity of computer−tomographic investigation in patients after CCT at different stages of post−comatose post−traumatic consciousness restoration, 220 patients in cerebral coma for at least 10 days from the moment of CCT were examined. Brain CT was performed three times within 12 months after injury to each patient in bone and parenchymal modes using standard positions. According to CT, the probability of recovery from coma with a higher level of post−comatose consciousness in severe CCT was higher in patients with combination of severe focal lesions with slight diffuse changes. In the presence of combination of severe focal and severe diffuse post−traumatic brain changes, the majority of patients remained in a vegetative state, with the exception of 6,12 % of patients who, during a year after a severe CCT, reached the stage of akinetic mutism. Thus, X−ray CT with the analysis of focal and diffuse changes in the brain at different stages in patients after severe CCT reveals new capabilities of the method in predicting the recovery of the level of post−comatose consciousness.
Key words: craniocerebral injury, coma, postcomatose consciousness disorders, X−ray computed tomography, neurorehabilitation.