Mild blast injury: vertigo complaints analysis

K. Trinus
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Abstract

The data about vestibular disorders resulting from blast injury are contradictory. To disclose the problem of vestibular disorder as the consequence of blast injury, we have done present investigation. One hundred and nine patients were examined: 65 Anti-Terroristic Operation (ATO) participants, who survived mild and moderate blast injury without cranial trauma, and 44 non-ATO patients (rhinitis, pharyngitis, otitis). Questionnaire “Types of dizziness” has been used according to the International Clinical Protocol on Vestibular Disorders (Dizziness). Complaints of dizziness (distortion of perception of space, movement and time) have been revealed in 70.77 % (46) ATO and 43.18 % (19) non-ATO patients: F-test = 0.51, T-test = 0.004, thus, showing that this complaint is not specific for mild traumatic brain injury (mTBI). Objective vertigo (sensation of subjects moving around the patient) met in 26.15 % (17) ATO and 11.56 % (5) non-ATO patients: F-test = 0.027, T-test = 0.046. So, we have two different qualitative groups. Тhese complaints are specific for the patients, who survived blast injury. Complaints of vertigo are also typical for the patients, who survived blast injury. Complaints of giddiness are specific for the patients, who survived blast injury. Imbalance and drop attacks are not typical for ATO patients. Complaints of kinetosis are specific for the patients, who survived blast injury. Orthostatics (discomfort sensations that appear after sudden standing up) has been revealed in 76.92 % (50) ATO and 47.73 % (21) non-ATO patients, this complaint is not specific for mTBI. Vestibular system organizes space orientation tetrad: vestibular, somatosensory, visual and hearing information to percept, orient and interact with environment. Acro-, nycto- and ascendophobia have appeared to be of no importance. Agoraphobia (Greek αγωρα — market, supermarket syndrome, discomfort in open, public places or crowds) has been detected in 33.85 % (22) ATO and 15.91 % (7) non-ATO patients. This complaint is not specific for mTBI. Claustrophobia (discomfort appearing in small, closed spaces) is met in 20.00 % (13) ATO and 9.09 % (4) non-ATO patients: F-test = 0.024, T-test = 0.10. Thus, we have two different qualitative groups. This is also interesting case, when we reveal qualitative difference without quantitative one. This is the argument to use F-test in our study. So, complaints of claustrophobia are specific for the patients, who survived blast injury. The same situation is with descendophobia (discomfort during walking down the hill or descending the staircase, patients note the necessity of visual control. It has been shown that among other signs, there is a positive correlation with age, imbalance, ascendophobia and dyspnea). The results are discussed from the point of view of the severe vestibular impairment due to the blast injury. Conclusions. 1. MBTI from blast injury is accompanied by severe stress, objective and subjective vertigo, giddiness and kinetosis, which are considered to be the symptoms of vestibular damage. 2. Dizziness, orthostatics and agoraphobia are quantitatively significantly increased in mBTI, but it might not be considered specific for blast injury consequences. 3. Giddiness, claustrophobia and descendophobia in ATO patients have no quantitative changes compared to the ENT patients, but are specific for mBTI after blast injury. 4. It is important to use matrix Fisher test in statistical examinations.
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轻度爆炸伤:眩晕主诉分析
关于爆炸损伤引起的前庭功能障碍的数据是相互矛盾的。为了揭示爆炸伤后前庭功能障碍的问题,我们进行了本研究。109名患者接受了检查:65名反恐行动(ATO)参与者,他们在轻度和中度爆炸伤中幸存,没有颅脑损伤,44名非ATO患者(鼻炎,咽炎,中耳炎)。调查问卷“头晕类型”是根据前庭疾病(头晕)国际临床协议使用的。70.77%的ATO患者(46例)和43.18%的非ATO患者(19例)出现头晕主诉(空间、运动和时间感知扭曲):f检验= 0.51,t检验= 0.004,因此,这种主诉不是轻度创伤性脑损伤(mTBI)特有的。26.15%(17例)ATO患者和11.56%(5例)非ATO患者出现客观眩晕(被试在患者周围移动的感觉):f检验= 0.027,t检验= 0.046。所以,我们有两个不同的定性组。Тhese投诉是针对那些在爆炸中幸存下来的病人。对于那些在爆炸中幸存下来的病人来说,眩晕也很常见。眩晕是那些在爆炸中幸存下来的病人特有的症状。失衡和跌落发作在ATO患者中并不常见。运动障碍的主诉是爆炸伤幸存者特有的。76.92%(50例)ATO患者和47.73%(21例)非ATO患者出现矫形(突然站起来后出现不适感),这种主诉并非mTBI特有。前庭系统组织空间定向四分体:前庭、体感、视觉和听觉信息来感知、定位和与环境相互作用。横向、纵向和上升恐惧症似乎并不重要。广场恐怖症(希腊αγωρα -市场、超市综合征,露天、公共场所或人群不适)在33.85%(22例)ATO和15.91%(7例)非ATO患者中检测到。这个抱怨不是针对mTBI的。幽闭恐惧症(出现在狭小封闭空间的不适)在20.00% (13)ATO患者和9.09%(4)非ATO患者中存在:f检验= 0.024,t检验= 0.10。因此,我们有两个不同的定性组。这也是一个有趣的例子,当我们揭示质的差异而不揭示量的差异时。这就是在我们的研究中使用f检验的理由。所以,幽闭恐惧症的症状是针对那些在爆炸中幸存下来的病人的。下山恐惧症(下山或下楼梯时感到不适)也是同样的情况,患者注意到视觉控制的必要性。研究表明,在其他迹象中,与年龄、失衡、上升恐惧症和呼吸困难呈正相关。本文从爆炸致严重前庭损伤的角度对结果进行了讨论。结论:1。爆炸伤所致MBTI伴有严重的应激、主客观眩晕、眩晕和运动障碍,被认为是前庭损伤的症状。2. 在mBTI患者中,眩晕、直立和广场恐怖症在数量上显著增加,但可能不被认为是爆炸伤害后果的特异性。3.与耳鼻喉科患者相比,ATO患者的眩晕、幽闭恐怖症和下降恐惧症没有定量变化,但这是mBTI在爆炸伤后特有的。4. 在统计检验中使用矩阵费雪检验是很重要的。
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