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4RESULTS OF ANALYZING NEUROLOGICAL SYMPTOMS IN ACUTE AND LONG-TERM PERIODS OF BRAIN CONCUSSION IN 63 PATIENTS
Mamadaliev A.M.
Mamadaliev Abdurakhmon Mamatkulovich - Doctor of medical sciences, professor DEPARTMENT OF NEUROSURGERY, SAMARKAND STATE MEDICAL UNIVERSITY, SAMARKAND, REPUBLIC OF UZBEKISTAN
Introduction: Brain concussion (BC) is a mild traumatic brain injury (TBI), it accounts for up to 90% of all cases of traumatic brain injury [1,2,3,4]. Annual economic losses of Russia due to injuries amount to 2.6% of GDP [5,6]. The significant frequency of residual effects and disability of victims after a concussion is currently fairly questioned, since the sample may include victims with mild, sometimes moderate brain contusions [7,8,9,10].
Despite the presence of numerous scientific studies devoted to the issues of the clinical course, diagnosis and treatment of concussion, there are still a number of controversial, mutually exclusive opinions due to the scarcity and ephemerality of the objective neurological symptoms of this disease [11,12].
The current lack of clear ideas about the frequency, severity and duration of the main symptoms in the acute period of concussion often leads to diagnostic errors, a decrease in the quality of treatment, the emergence of certain medical and social problems [13, 14, 15], requiring new research in this direction.
Aim of the study: The purpose of this study is to analyse the medico-social significance of neurological symptoms in the acute and long-term periods of concussion.
Material and research methods: The present study includes data from clinical and instrumental examination and treatment of 63 patients with a diagnosis of concussion at the age from 7 to 69 years, of which 25 children under 14 years old (39,7%), people from 15 to 45 years old - 29 ( 46,0%) and over 46 years old was 9 (14,3%). The examination of the patients was carried out according to a special chart, including the most important signs of clinical, follow-up examination - age, hospitalization period, signs of somatic and neurological status, dynamics of the course and treatment of the disease, data of X-ray, ophthalmological, echo- and electroencephalographic (EchoEG, EEG), computed tomographic (CT) and follow-up examination.
Research results and their discussion: The causes of concussion in 37 (58,7%) cases were a fall from a height, in 15 (23,8%) - road traffic accidents and in 11 (17,5%) - a blow to the head.
The main clinical signs of concussion were short-term impairment of consciousness, the presence of amnesia, cerebral and focal symptoms. All analyzed patients (100%) complained of headache, impaired consciousness (from several seconds to several minutes) was observed in 58 (92,1%) patients. The next general cerebral symptom was antero-con-retrograde amnesia (90,5%), followed by sleep disturbance (66,7%), dizziness (63,5%), nausea (57,1%) and vomiting (31,7 %).
Among the focal symptoms in most cases (84,1%), asymmetric hyperhidrosis was observed, which lasted until discharge from the hospital. In addition, the first days of hospitalization were marked by horizontal nystagmus (52,4%), the symptom of Marinescu - Radovic (39,7%) and tendon anisoreflexia (14,3%).
A concussion of the brain was often (96,8%) accompanied by asthenic syndrome, manifested by a significant decrease in mental performance, attention, memory, general weakness, and increased irritability. For clinicians (neurosurgeons, neurologists), forensic medical experts and commissions to determine the degree of work capacity of victims, clinical symptoms, the results of modern additional research methods, detected in acute and remote periods of concussion, are of great importance.
Conclusions:
The general cerebral concussion symptoms are manifested by headaches (100%), impaired consciousness (92,1%), amnesia (90,5%), sleep disturbances (66,7%), dizziness (63,5%), nausea (57,1%) and vomiting (31,7%). Focal concussion symptoms are hyperhidrosis (84,1%), horizontal nystagmus (52,4%), Marinescu-Radovic symptom (39,7%) and anisoreflexia (14,3%). Asthenic syndrome (96,8%) is manifested by a decrease in performance, attention, memory, general weakness, irritability and sleep disturbance.
The authors declare no conflicts of interest.
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