V. Shevaga, M. Semchyshyn, B. Zadorozhna, A. Zadorozhnyi
Danylo Halytsky Lviv National Medical University
Introduction. The proportion of brain injury is steadily increasing every year, remaining not only a medical but also a social problem, since it requires considerable economic costs both for diagnosis and treatment and for social rehabilitation of the victims. The common effective strategy for the treatment of traumatic brain damage is needed, which is aimed at reducing the lesion of the primary lesion and early diagnosis of possible secondary complications.
The aim of the study. To characterize types of electroencephalograms in patients with cerebral contusion of the mild severity in the acute period with subarachnoid and without subarachnoid hemorrhage.
Materials and methods. The study involved 108 of patients (27 women (25.00 %) and 81 men (75.00 %) aged 18 to 55 years). Among them, there are isolated 39 (36.11 %) sick (5 women (12.82 %) and 34 men (87.18 %) between 18 and 36 years of age) with cerebral contusion of the mild severity, aggravated subarachnoid hemorrhage and 69 (63.89 %) victims (22 women (31.88 %) and 47 men (68.12 %) aged 33 to 55 years) with cerebral contusion of the mild severity without hemorrhage. The control group consisted of 20 practically healthy individuals of the same sex and age (9 women (45.00 %) and 11 men (55.00 %) aged 20 to 50 years).
Electroencephalography was carried out using a computer complex DX-NT32.V19 when applying electrodes to international systems “10 – 20” with an ear indifferent electrode. The study protocol consisted of seven functional samples.
Statistical analysis was performed using the program “Statistica 6.0”, the values were considered reliable p < 0.05.
Results. The control group was characterized by normal EEG, and patients with a comparison group with cerebral contusion of the mild severity without subarachnoid hemorrhage, as well as patients in the study group with cerebral contusion of the mild severity with subarachnoid hemorrhage had normal, plane, border, synchronized and polyrhythmic types of EEG. In patients of the study group with cerebral contusion of the mild severity with subarachnoid hemorrhage in acute period polyrhythmic and synchronized types of EEG prevailed as opposed to the victims of the comparison group with cerebral contusion of the mild severity without hemorrhage, for which they are characteristic, types of EEG were plane, border and normal.
Analysis of the results of the study showed that in patients in the acute period of the cerebral contusion of the mild severity with subarachnoid hemorrhage, there was a significant difference with respect to all types of EEG (p < 0.05) control. In patients with cerebral contusion of the mild severity without subarachnoid hemorrhage in acute period a significant difference was observed only with respect plane (p1 < 0.05), normal (p1 < 0.05) and border (p1 < 0.05) types of EEG compared to control. Changes of polyrhythmic (p1 > 0.05) and synchronized (p1 > 0.05) types of EEG in patients with cerebral contusion of the mild severity without subarachnoid hemorrhage were unlikely compared to the control. Comparing the studied groups in the acute period of the cerebral contusion of the mild severity among ourselves, we found the significance of differences with respect to polyrhythmic (p2 < 0.05), synchronized (p2 < 0.05), normal (p2 < 0.05) and border (p2 < 0.05) types of EEG, and relatively plane types of EEG indicators were unreliable (p2 > 0.05).
Conclusions. These studies reflect the pathogenesis of trauma, point to the special role of nonspecific brainstem and hypothalamus systems, as triggers that lead to impaired cortical-subcortical and cerebral-spinal neurodynamics. Among the EEG characteristics, the most important for diagnosis is the phenomenon of synchronization, which reflects the phase of brain injury and is expressed by the rise of slow 5 (delta) and 9 (theta) waves. Pathological processes in the cerebral contusion of the mild severity of EEG are reflected by a combination of focal and cerebral changes in bioelectric activity and can be used for diagnostic and expert purposes.
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