PECULIARITIES OF THE CLINICAL COURSE AND APPROACHES TO SURGICAL TREATMENT
OF PATIENTS WITH EPIDURAL HEMATOMA AND ISOLATED TRAUMATIC BRAIN INJURY 

Mirzoyan Ayk Oganesovich, Candidate of medical sciences, neurosurgeon, unit of neural surgery, «Armenia» Republican Medical Center (6 Margaryan street, Erevan, Armenia) , m.hayk@mail.ru

617.51-003.215

Background. The article aims at studying peculiarities of the clinical course and approaches to surgical treatment of patients with epidural hematoma (EH) and isolated traumatic brain injury (ITBI).
Materials and methods. The author carried out a retrospective analysis. 188 medical records of operated patients with ITBI were studied. Epidural hematoma was found in 83 people (44,1%). Patients were divided in 3 groups according to clinical simptoms of patients – phases of the clinical course of TBI. The surgical approaches and outcomes of surgery of EH were studied in each group.
Results. It was found that the patients with ITBI are often operated for EH. The most of them are people of working age. The majority of patients were hospitalized at the stage of subcompensation of the clinical course of TBI. EH may develop in patients with depressed skull fractures, which can be determined by CT scan. Reception of patients at the stage of rough decompensation, lack of treatment in the prehospital period, a diagnostic error, delay in operation, hospitalization had a negative effect on the surgical treatment.
Conclusions. EH has a relatively favorable clinical course. A patient with ITBI should be examined with CT scan and operated in the first hours after reception of the patient in case of EH detection by CT scan. The dynamic CT scanning should be arranged in the preoperative period during 10–12 hours, if subarachnoid hemorrhage or meningeal hematoma was detected at the primary CT scan. In the postoperative period, intensive therapy should significantly reduce possibility of cerebral and extracerebral complications.

epidural, hematoma, craniocerebral trauma, treatment.

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