Craniocerebral trauma is one of the key problems of modern medicine in general and neurosurgery in particular. The overwhelming majority of patients, admitted to neurosurgical hospitals, is represented by casualties with craniocerebral trauma. As for Russian hospitals, surgical activity in trauma of the nervous system is 30-40% and the most widespread form of injuries is severe brain contusion and various types of its compression.
The book describes results of research, carried out by the authors during many years and aimed at studying disorders of cerebral circulation and metabolism in an acute period of severe craniocerebral trauma. First of all, it concerns brain crush focus. The authors were among the first scientists of the country, who started research in this field and did much for formation of a new approach to brain crush focus as a surgical form of brain injury.
The book is the first profound work, analyzing changes of cerebral circulation and metabolism, watched at the level of microcirculation in craniocerebral trauma. This research allowed to clarify pathogenesis of circulation disorders in brain crush foci. Morphologic (histoneurologic, ultrastructural, enzymatic-histochemical) study of brain crush foci under clinical and experimental conditions is an extremely good supplement to pathophysiologic information on a state of a cerebral circulation system, cerebrovascular reactivity and metabolism in brain crush focus in an acute period of severe craniocerebral trauma.
A complex of parameters of functional-structural changes, watched by the authors in brain crush focus, was analyzed. It allowed to give the first objective estimation of clinical manifestations of hypertension-dislocation syndrome, being the basis for determination of indications for surgical treatment.
The analysis of versions of surgical approaches in different localization of brain-compressing factors is accompanied by discussion of main peculiarities of developing hemodynamic responses, their parameters and expediency of using a differentiated approach to selection of surgical tactics.
There is no doubt about the book's importance. It will be very useful to neurosurgeons, experts in resuscitation, pathophysiologists and other medical specialists, interested in neurosurgery and neurotraumatology.
Khilko V.A. - Academician of RAMS,
Moskalenko Yu.E.- Professor