Posttraumatic Stress Disorder and Mild Traumatic Brain Injury – Common Consequences of War: Issues of Pathogenesis and Differential Diagnosis (Review)

Abstract

The article presents the modern views on the problem of wartime trauma, in particular, posttraumatic stress disorder (PTSD) and mild traumatic brain injury (TBI). Global epidemiological data on the prevalence of the above-mentioned conditions both among military personnel and among the civilian population are demonstrated. As for Ukraine, it is currently quite difficult to accurately determine the prevalence of PTSD and TBI in wartime conditions, but certain data are already available in the Ukrainian literature. Today, it can be assumed that a significant part of cases remains undiagnosed, especially in the case of PTSD. The situation is complicated by difficulties in accessing medical care in the war zones and in the occupied territory. The main pathogenetic mechanisms of the occurrence and relationship of PTSD and mild TBI were analyzed, in particular the development of oxidative stress, inflammatory response, neurotransmitter imbalance, activation of the hypothalamic-pituitary-adrenal system. Special attention is paid to the complex mechanisms of mine and explosive weapons impact on the human organism. The symptoms, criteria for diagnosis and differential diagnosis of the above pathological conditions are highlighted with reference to unified protocols. The main approaches to the management of such patients are considered, with an emphasis on a complex multidisciplinary approach with the involvement of related specialists, the necessity for constant dynamic monitoring by a family doctor. It is extremely important to involve the patient himself and his relatives in active participation in the treatment process in order to minimize the consequences of the trauma.