Insomniac disorders in patients with traumatic brain injury complicated with subdural hematoma

The objective: to determine the frequency of insomniac disorders in patients with traumatic brain injury (TBI) complicated with subdural hematoma, for early detection and prevention of sleep disorders in recovery periods.

Materials and methods. A survey was conducted in 102 patients with TBI complicated with acute subdural hematoma who were operated on in the Neurosurgical Department of the M.A. Tverye State medical center in Perm in the period from 2018 to 2019. The study included patients with the most frequent localization of subdural hematoma. Group I consisted of 31 patients (30%) with a hematoma localized in the frontotemporal region, group II - 28 patients (27%) with a hematoma localized in the parietal - temporal region, group III - 18 patients (18%) with a hematoma localized in the frontotemporal - occipital region, group IV - 25 patients (25%) with a hematoma localized in the parietal-occipital region. On day 13-14 after surgical intervention to remove the subdural hematoma, the patients were interviewed using the ISI scale to determine the presence and severity of insomnia.

Results. The severity of condition on admission was assessed as 13-12 points on the Glasgow scale in the largest number of patients. The most severe general condition on admission was noted in patients with subdural hematoma localized in the frontal-parietal-occipital area. Out of 102 patients, only one patient was found to have moderate sleep disturbances when assessing the insomnia severity index and 13 patients were found to have mild sleep disturbances. The most common complaints of the patients when interviewed were a feeling of heaviness in the head after sleep, intermittent, shallow sleep.

Conclusion. Interrupted sleep and heaviness in the head afterwards, as well as the need for daytime sleep, are the most frequent complaints about the sleep process in patients with a traumatic brain injury complicated with a subdural hematoma on the 13th-14th day after injury.

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