[Errors in the diagnosis and treatment of severe craniocerebral injuries complicated by shock]. / Oshibki v diagnostike i lechenii sochetannykh tiazhelykh cherepno-mozgovykh travm, oslozhnennykh shokom.

The frequency and character of errors in the diagnosis and treatment of 239 patients with shock mainly caused by a severe craniocerebral injury combined with other damages were studied. It was established that the percentage of diagnostic errors in these cases was quite high both in the prehospital stage and in the hospital (41 and 23%, respectively). Such injuries take o latent course, masking each other. It is shown that craniocerebral injury and blood loss have an aggravating effect on shock developing in a combined trauma. The advancing cerebral hypoxia in severe shock intensifies the affection of the brain caused by the direct trauma, which makes the diagnosis of craniocerebral and extracranial injuries very difficult. Underestimation of the severity of the developing shock leads to deficient antishock therapy.