Features of clinics and therapy of secondary meningoencephalitis in traumatic brain injury
Keywords:traumatic brain injury, secondary meningoencephalitis, pyoinflammatory complications, antibacterial therapy, intrathecal therapy, liquorrhea
Objective. To increase efficacy of treatment of patients with secondary meningoencephalitis (SME) during intermediate period of traumatic brain injury (TBI) by including intratecal methods into complex of intensive care.
Materials and methods. It is shown the results of examination and treatment of 23 patients with SME within intermediate period of TBI. Manifestations of SME were kept more than 2 months in the most of patients despite on intensive therapy they had received within acute period, which definitely increased patients’ condition after TBI, complicated prognosis for live and recover.
Results. Predictors for prolonged, palindromic course of SME for this patients were: nasty TBI, liquorrhea, resistance of microflora to used antibacterial medicines, development of other intracranial complications such as abscess, hidrocephaly, ventriculitis. It is demonstrated a necessity of timely updating of traditional systemic antibacterial therapy by intrathecal one to efective sanation of liquor, correction of liquor pressure and dynamic monitoring of liquorologic indices.
Conclusions. Recommended tactic of treatment allowed receive durable positive clinical and liquorological effect in 73.9% of patients even on second week of therapy. It was diagnosed virus-bacerial mixt-infection in 17.4% of incidences for patients with SME due to reactivation of herpesviruses, which is necessary to take into account for diagnostic and treatment of SME.
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Copyright (c) 2015 Elena Panasyuk, Sergiy Borshchov, Victor Matiash, Vladimir Trikhleb, Daria Govorova
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