[Changes in human cerebral cortex in various areas of concussion in severe cranio-cerebral injury].

In 23 patients with a severe cranial-cerebral trauma the operative material (pieces of the cortex, obtained from the destructive, transitional and relatively preserved zones in the bruise foci with crushing, localized in various lobules of the cerebral hemispheres) has been studied. From 2 h up to 9 days after trauma, changes, characterizing the state of the vascular bed, nervous and glial cells have been followed. In the external area of the transitional zone in 15 patients and in the relatively preserved zone in all the patients reversibly altered nervous cells predominate. Only in the destructive zone in all 23 patients and in the whole transitional zone in 8 patients neurons in all cortical layers are deeply injured and unviable. Certain considerations on differential surgical tactics, when treating the bruise foci with crushing at a severe cranial and cerebral trauma are presented.