Medical news
of the North Caucasus
Scientific journal
Mass media registration certificate dated December 7, 2006.
Series ПИ #ФС 77-26521.
Federal service for surveillance over non-violation of the legislation in the sphere of mass communications and protection of cultural heritage.
ISSN 2073-8137

Site search

Correspondence address
310 Mira Street, Stavropol, Russia, 355017

+7 865 2352511, +7 865 2353229.


Clinical and neurophysiological features of different in structure combined traumas

Evgenia Olegovna Nazarova; Sergei Karpov; Arthur Eduardovich Apaguni; Aleksey Karpov; Sergey Vyacheslavovich Krokhmal´;

The study included 102 patients with a combination of brain concussion (BC) and skeletal and thoracic injuries. The control group, 32 patients with isolated BC, was included. Neuropsychological testing and neurophysiological studies of EEG, HRV and P300 were performed. Depressive and asthenic disorders were revealed in the vast majority of patients with combined trauma. Cognitive decline was more marked in patients with thoracic combined trauma. The asymmetry of cortical activity of the brain prevailed in patients with the combined pelvicinjury. And vegetative regulation was characterized by the prevalence of parasympathetic influence against the background of increased sympathetic reactivity throughout the acute period. Thus, due to the difference in the mechanisms of «mutual burdening», the structures of the clinical course and specific neurophysiological characteristics differ in their structure.


1. Aldrian S.,Wernhart S., Negrin L. Epidemiological and economic aspects of polytrauma management in Austria. Wien Klin. Wochenschr. 2012;124(3):78-84. https://doi.org/10.1007/s00508-011-0105-x
2. Styazkina S. N., Shanina S., Merzlyakova D. A. Combined injuries. Synergy of Sciences. 2018;22:1290–1293.
3. Krestan C. R., HeroldС. Polytrauma. Radiology. 2014;54(9):859-860. https://doi.org/10.1007/s00117-013-2633-z
4. Pfeifer R., Pape H. C. Diagnostics and treatment strategies for multiple trauma patients. Chirurg. 2016;87(2):165-173. https://doi:10.1007/s00104-015-0139-0
5. Contractor A. A., Brown L. A., Weiss N. H. Relation between lifespan polytrauma typologies and post-trauma mental health. Compr. Psychiatry. 2018;80:202-213. https://doi.org/10.1016/j.comppsych.2017.10.005
6. Karpov S. M., Nazarova E. O., Azoidis I. Characteristics of the neuropsychiatric status of patients in the acute phase of combined trauma. European Journal of Neurology. 2016;23(2):727-728.
7. Likhterman B. L. Neurology of Traumatic Brain Injury. Moscow. 2009.
8. Smith C. Neurotrauma. Handb. Clin. Neurol. 2017;145:115-132. https://doi.org/10.1016/B978-0-12-802395-2.00008-0
9. Redwan B., Biancosino С., Nikolova К. Management of Thoracic Trauma. Zentralbl Chir. 2017;142(4):421-427. https://doi.org/10.1055/s-0043-116216
10. Beitl E. V., Banasova M., Vlcek В. Nitric oxide as an indicator for severity of injury in polytrauma. Physiol. Res. 2017;66(4):551-555.
11. Kobeissy F. H. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects. Boca Raton (FL):CRC Press/Taylor & Francis. 2015.
12. Larsen P., Goethgen С. В., Rasmussen S. One-year development of QOL following orthopaedicpolytrauma:a prospective observational cohort study of 53 patients. Arch. Orthop. Trauma Surg. 2016;136(11):1539-1546.
13. Mörsdorf P., Becker S., Holstein J. H. Quality of life after multiple trauma. Chirurg. 2014;85(3):210-214. https://doi.org/10.1007/s00104-013-2601-1
14. Nazarova E. O., Karpov S. M., Apaguni A. E. Cliniconeurophysiological features of combined injuries in the acute period. European Journal of Neurology. 2018;25(2):624. https://doi.org/10.1111/ene.13701
15. Christophorado D. Yu., Karpov S. M. Combined maxillofacial trauma, diagnostic issues, neurophysiological aspects. Russian dental journal. 2011;6:23-24.
16. Eliseyeva E. V., Sharipov Е. М., Gandylyan K. S., Suyunova D. D. Adaptation mechanisms in patients with craniofacial trauma. Medicinskii vestnik Severnogo Kavkaza. – Medical News of North Caucasus.2014;9(3):217-220. https://doi.org/10.14300/mnnc.2014.09061

Keywords: combined trauma, vegetative regulation, mutual burdening syndrome

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy