The book is based on fifty years of neurological experience and neurotrauma research of the author. Modern clinical classification of traumatic brain injury (TBI) is presented, including different forms of injury, degrees of consciousness' impairment, evaluation of severity of patient's condition.
Original classification of head injury complications and sequelae is presented which includes their detailed definitions and clinical and pathological varieties. There is a detailed description of TBI semiotics. Three classes of symptoms are delineated: symptoms of excitation, symptoms of irritation and symptoms of disconnection. Main syndromes are described with reference to their localization, etiology, methods of investigation, degree of severity and clinical significance.
Most of the book is dedicated to special neurotraumatology. Chapters on focal and diffuse brain injuries have identical structure and include sections on their definition, epidemiology, pathology and pathogenesis, clinical description, diagnosis, treatment, prognosis and outcomes.
Results of original investigations of cerebral concussion in acute, intermediate and remote period of TBI are presented. Hospitalized and non-hospitalized patients with cerebral concussion had identical clinical course and outcomes (provided that preexisting pathogenic factors are excluded). A new algorithm of organization of medical care after cerebral concussion is suggested.
Indications for differentiated (surgical or medical) treatment of severe brain injuries are established. Dynamics of clinical symptoms of cerebral contusions, intracranial hematomas and diffuse axonal injuries is complemented by CT and MRI investigations.
Conceptual approaches to management of main forms head injury sequelae (chronic subdural hematomas, basal CSF fistulae, hydrocephalus, skull defects, injury of vessels) are suggested including minimally invasive and reconstructive surgery. Clinical thinking and ethical problems in neurosurgery are also considered.