Международный неврологический журнал Том 22, №3, 2026

Поєднана краніофаціальна травма часто супроводжується легкою черепно-мозковою травмою, однак струс головного мозку може залишатися недіагностованим через домінування анатомічно очевидних ушкоджень лицевого скелета та неспецифічність неврологічних проявів. Метою огляду було узагальнити сучасні дані щодо місця струсу головного мозку у структурі поєднаної краніофаціальної травми, особливостей його клінічної діагностики, функціональних наслідків і принципів мультидисциплінарного ведення пацієнтів. Проведено наративний огляд клінічних настанов, систематичних оглядів, метааналізів і клінічних досліджень, пошук яких здійснювали в базах PubMed/Medline та Cochrane Library із використанням термінів, що стосувалися струсу головного мозку, легкої черепно-мозкової, щелепно-лицевої та краніофаціальної травми, постконтузійних симптомів і нейросенсорних порушень. Встановлено, що ризик поєднаного ушкодження мозку підвищується при високоенергетичних механізмах травми, а переломи середньої та верхньої зон обличчя можуть свідчити про передачу значної травматичної енергії на структури черепа й мозку. Клінічний фенотип включає загальномозкові, когнітивні, вестибулярні, нейроокулярні, цервікогенні та психоемоційні прояви, які можуть поєднуватися з ушкодженням трійчастого й лицевого нервів, нейросенсорним дефіцитом, болем і функціональними обмеженнями, пов’язаними з переломами та міжщелепною фіксацією. Недодіагностика струсу головного мозку може призводити до несвоєчасного надання рекомендацій щодо режиму, фізичного й когнітивного навантаження, подальшого спостереження та реабілітації, сприяючи персистуванню головного болю, запаморочення, когнітивних труднощів, розладів сну, тривожних і депресивних проявів. Струс головного мозку слід розглядати як провідний неврологічний компонент поєднаної краніофаціальної травми, що потребує активного скринінгу, повторної клінічної оцінки та скоординованої мультидисциплінарної допомоги.

Combined craniofacial trauma is frequently accompanied by mild traumatic brain injury; however, concussion may remain unrecognized because clinically apparent facial skeletal injuries dominate the initial assessment and neurological manifestations are often nonspecific. The aim of this review was to summarize current evidence on the role of concussion in combined craniofacial trauma, its diagnostic features, functional consequences, and principles of multidisciplinary patient management. A narrative review of clinical guidelines, systematic reviews, meta-analyses, and clinical studies was conducted. The literature search was performed in PubMed/MEDLINE and the Cochrane Library using terms related to concussion, mild traumatic brain injury, maxillofacial and craniofacial trauma, post-concussive symptoms, and neurosensory disorders. The available evidence indicates that the risk of concomitant brain injury increases in high-energy trauma, whereas fractures of the middle and upper facial thirds may reflect substantial transmission of traumatic energy to the skull and brain. The clinical phenotype includes cerebral, cognitive, vestibular, neuro-ophthalmological, cervicogenic, and psycho-emotional manifestations, which may coexist with trigeminal or facial nerve injury, neurosensory deficits, pain, and functional limitations associated with fractures and maxillomandibular fixation. Failure to recognize concussion may delay recommendations concerning regimen, physical and cognitive activity, follow-up, and rehabilitation and may contribute to persistent headache, dizziness, cognitive difficulties, sleep disturbance, anxiety, and depressive symptoms. Concussion should therefore be regarded as a principal neurological component of combined craniofacial trauma requiring active screening, repeated clinical assessment, and coordinated multidisciplinary care.

струс головного мозку; легка черепно-мозкова травма; краніофаціальна травма; щелепно-лицеві переломи; постконтузійні симптоми; огляд

concussion; mild traumatic brain injury; craniofacial trauma; maxillofacial fractures; post-concussive symptoms; review

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