METHOD FOR CHOOSING SURGICAL APPROACH TO LATERAL DISLOCATION OF BRAIN

摘要

FIELD: medicine.;SUBSTANCE: lateral dislocation index I_d is calculated taking into account a pathological growth volume according to the imaging findings, a midline offset, impairment of consciousness according to the Glasgow Coma Scale, lateral size of both lateral ventricles at the mid-level of a pellucid septum. In the patients with a craniocerebral injury: if I_d is less than 0.6, the surgery is not indicated; if I_d falls within the range of 0.7 to 1.2, the minimally invasive immediate surgery with removing the substrate causing the lateral dislocation is performed; if I_d is from 1.3 to 3.5, the immediate surgery with removing the substrate causing the lateral dislocation in a combination with a bone decompression with a trephine opening sized min 7×7 cm is performed; I_d exceeding 3.5 requires the immediate surgery with removing the substrate causing the lateral dislocation in a combination with expanded bone decompression with the trephine opening sized min 7×10 cm with infra-temporal decompression and extended plastic repair of a dura mater is performed. The similar calculations and measurements are performed in the patients suffering brain tumours causing lateral dislocation. The values I_d of less than 1.2 require the planned surgery; if I_d is from 1.3 to 3.5, the surgery is urgent, while the values I_d exceeding 3.5 provide the emergency surgery.;EFFECT: inventions enable determining the therapeutic approach reliably that is ensured by calculating the index taking into account the pathological growth volume, midline offset, impairment of consciousness, and lateral size of both lateral ventricles.;2 cl, 7 ex