Traumatic intracranial hipertension correction in patients with intracranial hematomas during the early postoperative period with the use of systemic angioprotector

Abstract

Post-traumatic brain edema is integral pathophysiological process in patients with severe traumatic brain injury, leading to increase of intracranial pressure (ICP). Intracranial hypertension (ICH), in turn, increases the number of deaths in this group of patients. The most important task in the treatment of victims in the early postoperative period after the removal of traumatic intracranial hematomas is correction of ICH syndrome.Purpose of the study. To evaluate the effect of the systemic angioprotector use on the treatment outcomes of patients with traumatic intracranial hematomas in the early postoperative period.Materials and methods. The study included 50 patients with traumatic intracranial hematomas. Group I — the main group (with the use of systemic angioprotector, n=24), group II — the comparison group (without the use of the medication, n=26). The effectiveness of treatment was compared — according to the following criteria: survival in the postoperative period (14 days), level of consciousness (at admission and average value during the day throughout the treatment), course of neurological status: meningeal signs, cranial nerve function, motor sphere, response to pain stimuli, autonomic system disorders (at admission and every day throughout the treatment), monitoring of ICP (before removal of the hematoma and average value throughout the measurement), changes in the multispiral computed tomogram of the head (at admission, on the 3rd, 7th, 14th day).Results. The study found that the mortality rate in the main group of patients with intracranial hematomas in the early postoperative period decreased by 21.5%. The average value of ICP for the entire period of measurement in group I is 15.0±7.6, in group II 17.3±8.4 mm Hg. The average value of points of the Glasgow com scale on the 14th day in group I is 9.2±1.9, in group II 7.5±0.7 points. The duration of intraventricular monitoring of ICP was less in the first group — 4.3±1.2 days, compared to the second group — 6.2±1.5 days.Conclusion. The use of systemic angioprotector in the complex treatment can reduce intracranial pressure (ICP) in patients with traumatic intracranial hematomas in the early postoperative period and improve intermediate outcomes.