BLAST-RELATED TRAUMATIC BRAIN INJURY: A COMPREHENSIVE ASSESSMENT OF RISK FACTORS AND REHABILITATION PERSPECTIVES (review of the literature)

This article addresses one of the most pressing issues in contemporary medicine in Ukraine — traumatic brain injury (TBI) in the context of war. The authors focus on blast-induced brain injuries, which are complex, multifaceted, and often associated with severe consequences. Particular attention is given to the specific characteristics of combat-related TBIs and the mechanisms of injury, including shock waves, barotrauma, shrapnel wounds, toxic exposure, and acoustic factors. The article explores a range of variables influencing the course and outcomes of TBI: genetic polymorphisms (APOE, BDNF, COMT), premorbid mental health conditions, recurrent injuries, situational factors at the time of trauma (e.g., stress, sleep deprivation, stimulant use), military culture, comorbid psychiatric disorders (especially PTSD), and the impact of domestic violence. These factors are shown to significantly affect recovery and functional prognosis. Special emphasis is placed on neurodegenerative processes, age-related aspects, and modern diagnostic and therapeutic approaches, including the use of biomarkers, neuroimaging techniques, novel pharmacological agents, and minimally invasive interventions for the treatment of chronic subdural hematoma. The article underscores the importance of an individualized, multifactorial approach to the treatment and rehabilitation of affected individuals.