CLINICAL OUTCOMES OF SEVERE TRAUMATIC BRAIN INJURY DEPENDING ON THE TYPE OF BRAIN DAMAGE AND THE SEVERITY OF TRAUMATIC DISLOCATION SYNDROME

Abstract

Background: Severe traumatic brain injury (sTBI) remains one of the leading causes of mortality and long-term disability worldwide. Clinical outcomes are largely determined by the morphological type of brain injury and the severity of traumatic dislocation syndrome (TDS), reflecting the extent of intracranial hypertension and brainstem involvement.
Objective: To evaluate treatment outcomes in patients with severe traumatic brain injury depending on the type of brain damage and the severity of traumatic dislocation syndrome.
Materials and Methods: A retrospective analysis of 216 patients with sTBI was conducted. Brain injury type was classified as diffuse brain injury or dislocation-type injury based on clinical course and computed tomography findings. The severity of TDS was staged according to the level of consciousness, brainstem reflex impairment, and vital function disturbances. Outcomes were assessed using the Glasgow Outcome Scale.
Results: Diffuse brain injury was associated with predominantly unfavorable outcomes, especially in patients with deep coma, with mortality reaching up to 69%. Early stages of TDS (I–II) were characterized by a significantly higher proportion of favorable outcomes, whereas advanced stages (III–V) demonstrated extremely high mortality rates, approaching 100% in terminal stages.
Conclusion: The type of brain damage and the severity of traumatic dislocation syndrome are decisive prognostic factors in severe traumatic brain injury. Early identification and management of dislocation processes are crucial for improving clinical outcomes.