In patients with complications due to PTE TBI, HD-tDCS causes a significant increase in CBV, CBF and a decrease in the average MTT, suggesting better oxygen delivery to tissue.

The article reports a clinical case illustrating favorable outcome of nonsurgical treatment of a polytraumazed patient with occult severe cerebral fat embolism. The peculiar characteristics of the perfusion CT are demonstrated.

Zero-fl ow pressure (ZFP) is an important parameter of a microcirculation. The aim is to determine the status of the ZFP at concomitant traumatic brain injury with and without the development of intracranial hematomas. Material and Methods:The results of the treatment of 80 patients with severe head injury and polytrauma was studied. M:F -44:36. Their average age was 34.3 ± 14.5 years (min 15: max 73). Depending on the presence of intracranial hemorrhages the patients were divided into 2 groups. Wakefulness according to Glasgow Coma Score (GCS) was 10.4 ± 2.6 in the 1st group and 10.6 ± 2.8 in the 2nd group. The Injury Severity Score (ISS) was 32 ± 8 in the 1st group and 31 ± 11 in the 2nd group. Epidural hematomas were revealed in the 2nd group in 7 patients, subdural hematomas in 27 persons and multiple hematomas in 4 sufferers. All the sufferers were operated within the fi rst 3 days. During the fi rst day 30 patients (78.9%) were operated.All the patients were subjected to the transcranial Doppler of the both middle cerebral arteries and the evaluation of the mean arterial pressure. Based on the data obtained the cerebral perfusion pressure and the ZFP were calculated. The comparisons between the groups were performed by using the Student's t-criterion. Results:There was no signifi cant difference in ZFP between the left side and the right side in 1 st group (46.88±14.05 mmHg vs. 45.44±10.73 mmHg, respectively, t=0.45; р=0.65) The average ZFP values in each of the groups (with or without hematomas) appeared to be statistically signifi cantly higher than a mean value in control group (32,9 ± 3,6 mmHg, р<0.01). The intergroup comparison of the ZFP showed a statistically reliable increase in its level in the 2nd group on the side of the removed hematoma as compared with opposite side (56.02±21.68 mmHg vs. 45.43±16.71 mmHg, respectively, t=2.38; р=0.019p=0,019).

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