Achievements in the provision of surgical care to victims with severe traumatic brain in jury under the conditions of the Republican Scientific Center for Emergency Medical Aid , twenty years of experience

K.E. Makhkamov , A.B. Salaev , M.K. Makhkamov , D.U. Israilov

Abstract

Aim: to assess the results of the activities of the neurosurgical service of the Republican Research Center of
Emergency Medicine (RRCEM) over a twenty-year period of operation with an analysis of the results of the
provision of surgical care to victims with TBI.
Material and methods. The archival data of 70 thousand patients who have been on treatment since 2001
have been analyzed, of which 30 thousand cases underwent surgical treatment. A comparative analysis of the
developed new methods of treatment in the neurosurgical department of the RRCEM was carried out.
Results: According to our data, brain contusion with isolated traumatic brain injury occurs in 18.2% of cases.
A new method of surgical treatment of TBI is proposed - an additional microsurgical opening of the brain
cisterns with the standardization of the operation technique. It was revealed that in patients with postoperative
control of intracranial pressure (ICP), there is a decrease in mortality to 5%. Based on a comparative analysis
of treatment results, a new algorithm for the treatment of patients with TBI and a scale for non-invasive
assessment of ICP have been developed. At the same time, there is a tendency towards a decrease in the overall
mortality rate, an increase in the survival rate of patients with initial impairment of consciousness to coma.