Indicators of rheoencephalography in recurrent acutraumatic lesions in real combat conditions

Abstract

Topicality: Recurrent acute trauma is common in patients who have received acutrauma in the combat zone. In such patients it is advisable to diagnose cerebral hemodynamic disorders for timely targeted medical care. Objectives of the study: The purpose of the work is to assess the quantitative and qualitative indicators of rheoencephalography in servicemen who received repeated acute trauma in real combat conditions. Materials and methods: We analysed the rheoencephalography of 52 patients with recurrent acute trauma and 15 healthy normal hearing subjects. Results: In the qualitative assessment of the rheograms of the examined patients, we found signs of cerebral circulatory disorders in both carotid (FM) and vertebrobasilar (OM) systems. In 28,3 % of the surveyed OOS fighters, we observed an increase in the tone of cerebral vessels with symptoms of angiospasm. Difficulty with venous outflow occurred in 72,1 % of cases in the carotid system and in 87,6 % - in the vertebrobasilar. Among the studied patients, we also often recorded a decrease in cerebral vascular tone (25,7 %) and cases of atonic curve (24,1 %). There was a significant proportion of patients with unstable vascular tone with a tendency to increase it 47,4 % or decrease 27,7 % in both cerebral circulatory systems. With regard to pulse blood supply, in patients with acutrauma were recorded (58,2 %) cases of its reduction in the carotid system and (89,7 %) in the vertebrobasilar basin. In the vertebrobasilar system, the asymmetry of REG curves (12,1 %) was also observed in real combat conditions. Analysis of quantitative indicators of REG in the carotid and vertebrobasilar systems in the subjects compared with the control group (K) revealed the following. In the examined patients there were changes in cerebral vascular tone and difficulty in venous outflow, as well as a decrease in pulse blood supply, as evidenced by significant changes in α, dichroic (DKI), diastolic (DSI) and rheographic (RI) indices of the REG curve. Thus, in the vertebrobasilar system, the value of Pi, which characterizes the pulse blood supply, was 0,57±0,04 (P<0,01) (at a rate of 1,19±0,03), and DKI was 59,63±1,18% (P<0,01) (at a rate of 51,2±1,4%). Thus, in patients with recurrent acute trauma there are severe disorders of cerebral circulation, especially in the vertebrobasilar basin. Conclusions: 1. According to rheoencephalography, fighters who received repeated acute trauma in the area of environmental protection have severe cerebrovascular disorders, with venous outflow difficulties, decreased pulse blood flow, tendency to decrease and unstable tone of cerebral vessels predominate. 2. Significant (P<0,05) deviations from the norm in the indicators of DKI, DSI and Ri, especially in the vertebrobasilar basin, take place in the examined fighters with repeated acute trauma. This indicates a pronounced violation of cerebral circulation, venous outflow and decreased pulse blood supply during repeated combat acutrauma. 3. In case of repeated combat acutrauma, there are pronounced extraural disorders of the cerebral circulation, which need to be taken into account when providing medical care to such patients.