Modern approaches to the management of traumatic brain injury

Abstract

The authors report on the problem of Traumatic Brain Injury(TBI) and main ways of its solution. Special emphasis is beingplaced on literature data bank and personal experience in studyingand making precise diagnosis of diffuse and focal brain damageusing Diffuse-tensor MRI (DT-MRI) and its other modalities.A comparative analysis of DT-MRI findings in 8 healthyvolunteers and 22 patients in coma with severe diffuse axonalinjury (DAI) at the period of 217 days after trauma demonstratedsignificant changes in the corpus callosum and corticospinaltracts (CST) caused by DAI. Fractional anisotropy wasconsidered the most sensitive indicator of their damage in theearly stage of DAI. The authors developed and described a newapproach to the management of brain concussion which allows out-patient treatment of such patients provided there is no focaldamage at GCS 15 and on condition thorough neurological andregular CT- and MRI examinations are performed.

Keywords

• head injury
• neuroprotection
• mri
• diffuse axonal injury
• brain concussion