ISOLATED SEVERE TRAUMATIC BRAIN INJURY: CLINICAL COURSE AND OUTCOMES (RETROSPECTIVE ANALYSIS)
The article presents retrospective analysis of data obtained from 93 case histories of patients with severe traumatic brain injury (STBI) operated on the basis of the City Clinical Hospital No. 1 named after A. N. Kabanov in 2016. The most frequent mechanisms of receiving isolated STBI are identified: criminal trauma and falling from height. The fatal outcome after surgical treatment was 60.6% (20 victims). According to the results of forensic studies, the causes of death were as follows: edema and dislocation of the brain - in 8 patients (40%), edema, dislocation and pneumonia simultaneously - in 9 patients (45%), edema, dislocation of the brain and purulent-septic complications - in 2 patients (10%), pneumonia - in 1 patient (5%). The main risk factors for death were: depression of the consciousness according to Glasgow coma scale (GCS) up to 9 points or less, presence of bilateral mydriasis, muscle hypertonus, the presence of pathological reflexes in the neurological status, volume of the focus of brain damage more than 80 cm3, lateral dislocation more than 6 mm according to imaging methods. The data obtained can be used for emergency care and prognoses assessment in patients with isolated STBI.