Когнитивные и психоэмоциональные нарушения у детей после черепно-мозговой травмы: причины возникновения, клиника и терапия

Черепно-мозговая травма (ЧМТ) является серьезной проблемой общественного здравоохранения, затрагивающая не менее 3 млн детей во всем мире каждый год и может приводить к смерти или инвалидности, особенно часто у пациентов с умеренной или тяжелой формой ЧМТ. В России, по данным федеральной службы государственной статистики (Росстат), за 2023 г. у детей в возрасте от 0 до 17 лет зарегистрировано 1 014,3 тыс. случаев травмы головы (в пересчете на 100 тыс. детского населения – 3 353,5), что уступает по численности только травмам запястья / кисти и травмам области голеностопного сустава / стопы. Дети, перенесшие ЧМТ, могут страдать не только от двигательных нарушений при повреждении головного мозга, но также иметь комбинацию когнитивных, поведенческих и эмоциональных нарушений, которые могут сохраняться длительный период времени после травмы. У детей с умеренной и тяжелой ЧМТ возникает дефицит, который сохраняется и во взрослом возрасте, влияя на результаты обучения и дальнейшего трудоустройства, психосоциальное функционирование и качество жизни. Посткоммоционный синдром как наиболее частое осложнение легкой ЧМТ может развиваться во всех возрастных группах. Было доказано, что нарушения управляющей функции присутствуют как во время острой фазы восстановления после ЧМТ, так и могут сохраняться в долгосрочной перспективе. Управляющие функции имеют решающее значение для академической успеваемости и общего развития ребенка. В настоящее время проводится поиск биомаркеров крови, которые помогут обеспечить объективные показатели тяжести травмы, помочь выявить детей с риском замедленного восстановления функций ЦНС. Медицинская помощь детям с ЧМТ должна иметь мультидисциплинарный подход с созданием индивидуальных траекторий восстановительных программ с учетом выявленных нарушений. Холина альфосцерат является перспективным эффективным препаратом для коррекции нарушений нервно-психического развития и восстановления когнитивных функций у детей после ЧМТ.

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