Traumatic brain injury (TBI) is one of the major causes of death and disability in young and middle-aged people. The most problematic group is comprised of patients with severe TBI who are in a coma. The adequate diagnosis of primary brain injuries and timely prevention and treatment of the secondary injury mechanisms largely define the possibility of reducing mortality and severe disabling consequences. When developing these guidelines, we used our experience in the development of international and national recommendations for the diagnosis and treatment of mild traumatic brain injury, penetrating gunshot wounds to the skull and brain, severe traumatic brain injury, and severe consequences of brain injuries, including a vegetative state. In addition, we used international and national guidelines for the diagnosis, intensive care, and surgical treatment of severe traumatic brain injury, which had been published in recent years. The proposed guidelines concern intensive care of severe TBI in adults and are particularly intended for neurosurgeons, neurologists, neuroradiologists, anesthesiologists, and intensivists who are routinely involved in the treatment of these patients.

No abstract

Traumatic brain injury (TBI) is one of the main causes of mortality and severe disability in young and middle age patients. Patients with severe TBI, who are in coma, are of particular concern. Adequate diagnosis of primary brain injuries and timely prevention and treatment of secondary injury mechanisms markedly affect the possibility of reducing mortality and severe disability. The present guidelines are based on the authors' experience in developing international and national recommendations for the diagnosis and treatment of mild TBI, penetrating gunshot wounds of the skull and brain, severe TBI, and severe consequences of brain injury, including a vegetative state. In addition, we used the materials of international and national guidelines for the diagnosis, intensive care, and surgical treatment of severe TBI, which were published in recent years. The proposed recommendations for surgical treatment of severe TBI in adults are addressed primarily to neurosurgeons, neurologists, neuroradiologists, anesthesiologists, and intensivists who are routinely involved in treating these patients.

ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯСердечно-сосудистые заболевания занимают первое место по распространенности среди населения экономи-чески развитых стран и лидируют в структуре причин ин-валидизации и смертности [1]. По данным ВОЗ [2], от со-судистых заболеваний сердца и головного мозга в мире ежегодно умирают около 17,5 млн человек (что составляет 30% смертности от всех заболеваний). В экономически развитых странах первой причиной смертности является

В ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУ 3. Лечение больных с острой позвоночноспинномозговой травмой 3.1. Оказание первой медицинской помощи больным с подозрением на травму позвоночника на догоспитальном этапе Для оказания квалифицированной помощи на догоспитальном этапе пострадавшим с подозрением на позвоночно-спинномозговую травму (ПСМТ) обязательно соблюдение следующих условий. 1. Каждой бригаде скорой медицинской помощи (СМП) иметь жесткий головодержатель, метилпреднизолон и жесткие или вакуумные носилки (опция). 2. Любой пациент с подозрением на травму позвоночника, в том числе больные в бессознательном состоянии, после дорожно-транспортного проис