Clinical and instrumental characteristics of mild traumatic brain injury and acubarotrauma due to the impact of an explosive shock wave

BACKGROUND: Traumatic brain injuries are widespread and need to be studied, having a serious impact on health and the economy. Every year, about 69 million people experience traumatic brain injuries, including road accidents and military conflicts. A number of studies show that up to 20% of veterans who have returned from Iraq and Afghanistan, got a mild head injury. 83% of those hospitalized between 2001 and 2018 had a mild traumatic brain injuries. Pathophysiological processes in traumatic brain injuries include axon loss and demyelination, which disrupts the functioning of neural networks and manifests itself in the form of instability, cognitive decline, and mental changes. The causes of instability can be associated with damage to the vestibular apparatus, conducting pathways and connections of the cerebellum and cortical analyzers, which can be detected by modern neuroimaging methods. Stabilometry using a power platform is a promising diagnostic method for light therapy. traumatic brain injuries, which allows you to study the equilibrium function.

AIM: to determine the clinical and instrumental characteristics of mild traumatic brain injury and acubarotrauma due to the impact of a shock blast wave separately and in combination.

MATERIALS AND METHODS: 66 patients were selected (n = 66) aged 18 to 56 years (38.28 ± 9.98 years) who were exposed to a shock wave. Of these, 28 (42.4%) patients with mild traumatic brain injury (group 1), 21 (31.8%) patients with isolated acubarotrauma (group 2), with a combination of mild traumatic brain injury and acubarotrauma in 17 (25.8%) patients (group 3). Age, presence of chronic diseases, neurological status, neuropsychological examination, stabilometric examination, computed tomography and magnetic resonance imaging of the brain were evaluated. The table editor (MS Excel 2019) was used for statistical data processing and the program for medical and biological research (STATISTICA 12).

RESULTS: the diagnosis of mild traumatic brain injury and acubarotrauma was established based on clinical recommendations. In the neurological status of all patients in groups 1 and 3, scattered organic symptoms were detected. In group 2, patients had a few isolated unstable neurological signs. According to neuropsychological testing, there was a deterioration in the results in group 3 compared to the group 1 and 2 (p < 0.05). A stabilometric study showed that in group 3 significantly worse indicators of the speed of the general center of pressure, the area of the statokinesiogram with both open and closed eyes were noted compared to the other groups (p < 0.05). According to the data of magnetic resonance imaging of the brain, including using SWI/SWAN sequences, diffuse micro-hemorrhages in the brain substance were not detected in the study groups.

CONCLUSION: the main characteristics of mild traumatic brain injury in combination with acubarotrauma include pronounced postural instability, deterioration of stabilometric parameters and cognitive functions.