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Associated cranio-cerebral katatraumas


Author: Postolachi Roman
Degree:doctor of medicine
Speciality: 14.00.28 - Neurosurgery
Year:2009
Scientific adviser: Stanislav Groppa
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Vasile Burunsus
doctor
Institution:

Status

The thesis was presented on the 3 September, 2008
Approved by NCAA on the 22 January, 2009

Abstract

Adobe PDF document0.37 Mb / in romanian

Thesis

CZU 616.831-001.3

Adobe PDF document 2.43 Mb / in romanian
156 pages


Keywords

associated cranio-cerebral katatraumas, neurological symptoms, cerebral matter

Summary

The results of a research of 330 patients with associated cranio-cerebral katatraumas are presented. The mean age of patients was 36,44 years, which signifies that katatraumas occured in young persons. The cranio-cerebral traumas associated with katatraumas are 2,55 more frequently versus those acquired after other traumatic mechanism.

The clinical neurological examination assessed that neurological signs in patients with associated cranio-cerebral katatraumas are specifically for different forms of association in acute and intermediary period of traumatic disease. There are characterized by a more pronounced evolution and are presented by neurological disturbances determined by injuries of cerebral cortex, white matters as well of basal ganglia, corpus callosum, brain stem, hypothalamus, spinal cord on a background of concussion or general contusion of suprasegmentar structures.

We stress the importance of intraventricular and subarahnoid hemorrhages (25,15%) which frequently were in association.

The results of the study showed that the neurological changes in associated cranio-cerebral katatraumas evolved in the majority of cases on the following background: traumatic shock, vital functions disturbances, overall severe state of patients, consciousness alterations, alcoholic state, affect reaction to trauma, associated injuries. The presence of this pathological background displays the importance of the neurological follow-up in acute period of traumatic disease.

The analysis of head traumas clinical forms with associated cranio-cerebral katatraumas allowed us to estimate severe cerebral injuries in 29,09% patients. We have estimated the volumes of unique hematomas bilateral to correspondent neurological symptoms. Only in these traumas we have determined the appearance of craniocerebral injuries after indirect traumatic mechanism in 18,8% patients.

Due to radiological data, CT, intraoperatory visualization of the cerebrum, morphological results, were pointed out the changes of cerebral matter and cranial bones specifically for katatraumas, having an important role in the pathogenesis of edema, vascular disturbances, and in the appearance of secondary injuries.

In order to prevent the associated cranio-cerebral katatraumas it is necessary to recommend the prophylaxis’s strategies, which must include the social programs, the change of the codes of building construction and legislation, change of the environment such as the creating protections for the windows and balconies balusters.