Complex oteneurological evaluation of vestibular disoders in mild blast traumatic brain injury

• Main Authors: O. Ye. Skobska, O. M. Kvasha, Yu. Ye. Pedachenko, O. S. Hotin, O. Yu. Malysheva
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2019-05-01
• Series: Patologìâ
• Subjects: mild traumatic brain injury; blast injuries; blast effect; computer stabilography; vestibular disorders
• Online Access: http://pat.zsmu.edu.ua/article/view/166171/167083

Due to the non-specific character of the symptoms complex and certain difficulties in clinical evaluation, it is important to develop diagnostic criteria for the vestibular symptoms in patients with blast traumatic brain injury due to the explosive effect for maintaining high quality of life and full social adaptation. Objective. To analyze the vestibular symptoms in those injured during a military traumatic injury due to an explosive effect. Materials and methods: the results of clinical and instrumental studies of 39 patients who were examined and treated in the neurotrauma department of the State Institution “Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine”, with documented mine-explosive head injury obtained in the armed conflict in Eastern Ukraine during the period of 2014–2017 were analyzed. Results: Most often and most clearly there is a certain stable clinical symptom complex; the statistically significant criteria of stabilographic indicators of quantitative assessment of the state of the vestibular system in patients with combat TBI caused by explosion were determined; the development and implementation of standardized evaluation and analysis of vestibular violations in combat TBI caused by explosions have an important clinical and expert value in the evaluation of vestibular dysfunction for medical-social and forensic medical examinations, timely adequate rehabilitation and social adaptation of participants of armed conflicts. Conclusions: According to the data of subjective audiometry, among examined patients with combat TBI caused by explosions, sensorineural hearing loss of various degrees of severity, including deafness was diagnosed in 29 (74.4 %) patients. Tonic audiometric curves of patients had mostly descending, or often a broken type. The complex of diagnostic criteria was based on the analysis of stabilographic indicators, specifically, the general center of gravity, the frequency-amplitude spectrum of the stabilogram, the integral index of the quality of the vestibular function for the definition of the vestibular system state of patients with combat TBI caused by explosions, that helps to determine the level of damage for the vestibular analyzer , the level of preservation of function and compensation of central regulatory mechanisms of the static-kinetic system. Violation of the vestibular function in combat TBI caused by explosions is an important military-civilian problem