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Yuri Alekseenko Department of Neurology and Neurosurgery Vitebsk Medical University Vitebsk, Belarus Istanbul, Turkey, 2005 "Zs Traumatic Brain Injury$ Othe incidence of TBI is high - between 229 and 1967 per 100,000 the highest incidence occurring in men, aged 15 to 24 years 90-95% of all traumatic brain injuries are considered mild (MTBI) Mild Traumatic Brain Injury. Revised Guidelines on Early Management. EFNS Task force on MTBI, Scientific Panel of Neurotraumatology, 2005 ^~DF F -   MTBI in patients with VD$ The diagnosis of mild traumatic brain injury (MTBI) and general assessment of neurological functions in patients with vascular dementia (VD) is usually complicated The assessment and interpretation of main MTBI or VD symptoms and history in such circumstances remains a challenge The distinction between traumatic and primary or secondary cerebral vascular effects is rather difficult Dv    d  MTBI + VD $  0HI + VD MTBI + VD MTBI VD decompensation Cerebrovascular disorders secondary MTBI (syncope, epileptic seizure, vertigo and imbalance disorders & ) FZZB>&  n ! VD and/or TBI$  4MTBI and/or VD decompensation and/or Traumatic intracranial complications (extracerebral haematoma, malignant brain oedema with diffuse brain swelling & )Z  .      8 MTBI diagnostic criteria$ ztrauma history hospital admission Glasgow Coma Score (GCS) of 13 15 brief (min/sec) loss or/and any alteration of consciousness (disorientation, confusion) at the time of the accident posttraumatic amnesia  several minutes/hours physical symptoms (nausea, vomiting, dizziness, headache, autonomic disorders, etc)>Z>0  5   MTBI+VD$  To clarify the reciprocal influence of such conditions and improve the standard diagnostic protocols we compared the structure of clinical signs and the natural course of recovery in MTBI young patients with those of MTBI+VD patients   Materials and methods$  61 young males with MTBI (aged 16-39) and 56 patients with MTBI (aged 56-78) on the background of mild and moderate VD The quantitative analysis (duration/intensity) of main MTBI symptoms was carried out   VD patients $   Underlying chronic cerebrovascular pathology: hypertensive encephalopathy (43%) arteriosclerotic encephalopathy (31%) combined (H+A+ toxic and metabolic) (26%) (0v.S  B MTBI diagnosis$ The criteria for selecting MTBI patients were as follows: brief (min/sec) loss or/and any alteration of consciousness (disorientation, confusion) at the time of the accident posttraumatic amnesia  several minutes/hours physical symptoms (nausea, vomiting, dizziness, headache, vegetative disorders, etc) absence of focal neurological deficit absence of scull fracture normal CT or MRI scan of the brain recovery preferably in 1-2 weeks (young patients) patients with significant concomitant neurological and internal diseases were excluded from this study (young patients) *CPyA  MTBI+VD$ MTBI+VD patients demonstrated more extensive and frequent disorders of consciousness and amnesia and their different structure in comparison with young MTBI patients at the time of accident =Disorders of consciousness and amnesia in patients with MTBI ><$(=   MTBI symptoms$  LOC and amnesia at the time of accident: Only 45% of MTBI+VD patients were able to confirm such disturbances by themselves in comparison with young MTBI patients (68%) 4)+   TBI signs $  The signs of head trauma (abrasions, bruises) as an indirect evidence of a probable brain injury were objectively observed in 84% of MTBI+VD patients compared with 72% of young MTBI patientsL 2 . 4 (   MTBI symptoms$  ,Such symptoms as headache, dizziness, nausea, vomiting, fatigue and some other autonomic disorders (orthostatic dysregulation and thermodysregulation) were the most common manifestations of MTBI Besides, MTBI and MTBI+VD patients demonstrate a wide variety of duration and intensity of such symptoms--.    MTBI symptoms$   MTBI+VD patients had more frequent nausea (92% and 79%) but at the same time they had less frequent vomiting in comparison with young MTBI patients (43% and 58% accordingly)    MTBI symptoms$  Different types of headache were observed in all young patients and only in 82% of MTBI+VD patients. At the same time headache and some other subjective disorders in patients with VD were less intensive, but went on a longer time    #%MTBI symptoms - headache$ &In all MTBI and only in 79% of MTBI+VD cases the headache appeared just after the trauma and gradually decreased during the first or the second week after the accident In 30% of all MTBI patients the most intensive headache, dizziness and nausea were observed on the next day after the trauma ''% &MTBI symptoms - headache$ RIn case of headache appearing some time after the trauma its interpretation as a MTBI symptom still remains controversial Remote headache in patients with MTBI might to a greater extent be associated with the influence of additional factors and other mechanisms (psychological reactions to physical or emotional stress and other causes)SSR  MTBI+VD$ In 74% of MBI+VD patients it could be considered as a decompensation of an underlying cerebrovascular pathology (chronic hypertensive or arteriosclerotic encephalopathy) on the background of MTBIT  ,  E  *   Conclusion $  The distinction between primary and secondary traumatic brain injury (due to syncope, seizure or vertigo, etc) in patients with VD as well as between neurological disorders of traumatic and secondary vascular origin remains rather difficult Persistent neurological dysfunctions including cognitive deficit after the MTBI in patients with VD could be interpreted in most cases as a complex clinical condition with predominance of the existing cerebrovascular pathologyZ<      Conclusion $  Chronic cerebrovascular pathology seem to decrease the "concussion threshold", simultaneously producing some disorganisation influence on brain mechanisms and contributing to patients decompensation after the MTBI , the spectrum of symptoms after the trauma may be wider CT or MRI should be considered in MTBI diagnostic protocol for patients with VD  bcV   8 Q v  0` r77f3/Ʊ` fff` KfxP` 7_/U<ff` HghXs3q̙` WXcklugti~^ӤO` ־3f3f` 33^` J%xiff3>?" dd@,?nFd@  d nF@ d`nF n?" dd@   @@``PP   @ ` ` p>> $(  $6 T ~ $ "~ $ c B@CW DEF"d@ W @W @W W @`".~ $ c B,CW DEF"d@ W ,W ,@`". \ ~ $ "~ $ c B CDEF"@   @`"(4 $ c B C DEF"d@ @`"(W4 $ c BtC DEF"d@t t tt@`"~  $ c B CDEF"@ @`"([4W  $ c B CDEF"d@ @`"(4  $ c B CDEF"2@  @`"(4[  $ c BC DEF"d@ @`"_  $ c BC DEF"@ @`" $ c BC DEF"@  @`"\ $ B0:  ?"0F   V"1@075F 703>;>2:0 j $ 0  "0   1@075F B5:AB0 B>@>9 C@>25=L "@5B89 C@>25=L '5B25@BK9 C@>25=L OBK9 C@>25=L M $ 0  "`P   \*  $ 0f  "`p    ^*  $ 0̀  "`0   ^* H $ 0޽h ? fff80___PPT10. @F$ Shimmer - 0 ((  ( T ~ ( "~~b ~ (# "~ ( c B@CW DEF"d@ W @W @W W @`".~ ( c B,CW DEF"d@ W ,W ,@`". 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"System;-@"Tahoma-. .2 IN PATIENTS WITH VASCULAR .. .2 IN PATIENTS WITH VASCULAR .-@"Tahoma-. 2 (DEMENTIA.. 2 'DEMENTIA.-@"Tahoma-. 2 =Yuri Alekseenkos.. 2 <Yuri Alekseenkos.-@"Tahoma-. C2 H(Department of Neurology and Neurosurgery.. C2 G(Department of Neurology and Neurosurgery.-@"Tahoma-. .2 MVitebsk Medical University.. .2 LVitebsk Medical University.-@"Tahoma-. 2 SVitebsk, Belarus.. 2 RVitebsk, Belarus.-@"Tahoma-. +2 hIstanbul, Turkey, 2005 .. +2 gIstanbul, Turkey, 2005 .-՜.+,0<    On-screen ShowHomezh ArialTahomaTimes New Roman WingdingsSymbolShimmer#Диаграмма Microsoft Graph@MILD TRAUMATIC BRAIN INJURY IN PATIENTS WITH VASCULAR DEMENTIATraumatic Brain InjuryMTBI in patients with VD MTBI + VDVD and/or TBIMTBI diagnostic criteriaMTBI+VDMaterials and methods VD patientsMTBI diagnosisMTBI+VD>Disorders of consciousness and amnesia in patients with MTBI MTBI symptoms TBI signsMTBI symptomsMTBI symptomsMTBI symptomsMTBI symptoms - headacheMTBI symptoms - headacheMTBI symptoms - headacheMTBI+VD Conclusion Conclusion  Fonts UsedDesign TemplateEmbedded OLE Servers Slide Titles(_.0nico stanculescunico stanculescu  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvxyz{|}~Root EntrydO)Pictures(Current UserSummaryInformation(w$VPowerPoint Document( RDocumentSummaryInformation8