Neurointensive care of severe traumatic brain injury
Summary of "Neurointensive care of severe traumatic brain injury"
We present a Danish algorithm for the neurointensive care of patients with severe traumatic brain injury. The primary goal is to avoid cerebral ischaemia and hypoxia and secondarily brain injury. Patient evaluation by a neurosurgeon is mandatory, and decision-making concerning extended cerebral monitoring should take place immediately. Treatment aiming at diminishing increased intracranial pressure should be initiated early. Early critical care management of patients with severe traumatic brain injury should be performed in a teamwork comprising various specialties.
Affiliation
Neurointensivt Terapiafsnit 2093, Neuroanaestesiologisk Klinik, Neurocentret, Rigshospitalet, 2100 København Ø, Denmark. karen-lise.welling@rh.regionh.dk
Journal Details
This article was published in the following journal.
Name: Ugeskrift for laeger
ISSN: 1603-6824
Pages: 2091-4
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20633342
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Coma, Post-head Injury
Prolonged unconsciousness from which the individual cannot be aroused, associated with traumatic injuries to the BRAIN. This may be defined as unconsciousness persisting for 6 hours or longer. Coma results from injury to both cerebral hemispheres or the RETICULAR FORMATION of the BRAIN STEM. Contributing mechanisms include DIFFUSE AXONAL INJURY and BRAIN EDEMA. (From J Neurotrauma 1997 Oct;14(10):699-713)
Brain Injuries
Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.
Head Injuries, Closed
Traumatic injuries to the cranium where the integrity of the skull is not compromised and no bone fragments or other objects penetrate the skull and dura mater. This frequently results in mechanical injury being transmitted to intracranial structures which may produce traumatic brain injuries, hemorrhage, or cranial nerve injury. (From Rowland, Merritt's Textbook of Neurology, 9th ed, p417)
Brain Hemorrhage, Traumatic
Bleeding within the brain as a result of penetrating and nonpenetrating CRANIOCEREBRAL TRAUMA. Traumatically induced hemorrhages may occur in any area of the brain, including the CEREBRUM; BRAIN STEM (see BRAIN STEM HEMORRHAGE, TRAUMATIC); and CEREBELLUM.
Brain Stem Hemorrhage, Traumatic
Bleeding into structures of BRAIN STEM, including the MIDBRAIN; PONS; or MEDULLA OBLONGATA, as the result of CRANIOCEREBRAL TRAUMA. DIFFUSE AXONAL INJURY is commonly associated. Clinical manifestations may include OCULAR MOTILITY DISORDERS; ATAXIA; PARALYSIS; PERSISTENT VEGETATIVE STATE; and COMA.
PubMed Articles
Nutritional therapy in traumatic brain injury : Update 2012.
Severe traumatic brain injury ranks among the most common causes of death in young adults in western countries. Severe traumatic brain injury is typically followed by a pronounced pathophysiological c...
OBJECTIVES:: To understand the gradient between rectal and brain temperature in children after severe traumatic brain injury. We hypothesized that the rectal temperature and brain temperature gradient...
Early estimation of prognosis for the patient with traumatic brain injury is an important factor in making treatment decisions, resource allocation, classify patients, or communicating with family. We...
Decompressive craniectomy in diffuse traumatic brain injury.
It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and refractory raised intracranial pressure.
Experimental traumatic brain injury.
ABSTRACT: Traumatic brain injury, a leading cause of death and disability, is a result of an outside force causing mechanical disruption of brain tissue and delayed pathogenic events which collectivel...
Clinical Trials
Hypothermia in Traumatic Brain Injury in Children (HiTBIC)
The purpose of this study is: - To determine the safety and feasibility of performing an international multi-centre randomized control trial of early and prolonged hypothermia to...
Progesterone for the Treatment of Traumatic Brain Injury
The ProTECT study will determine if intravenous (IV) progesterone (started within 4 hours of injury and given for a total of 96 hours), is more effective than placebo for treating victims...
Erythropoietin in Traumatic Brain Injury (EPO-TBI)
Many people who have a traumatic brain injury (TBI) - usually from a blow to the head such as in a vehicle collision or in a fall do not survive or, if they do, suffer from long-term disab...
Evaluation, Pathogenesis, and Outcome of Subjects With or Suspected Traumatic Brain Injury
Background: - Traumatic brain injury may have a range of effects, from severe and permanent disability to more subtle functional and cognitive deficits that often go undetected during ini...
Study of Citicoline for the Treatment of Traumatic Brain Injury (COBRIT)
The Citicoline Brain Injury Treatment (COBRIT) is a randomized, double-blind, placebo controlled, multi-center trial of the effects of 90 days of citicoline on functional outcome in patien...
