Severe traumatic brain injury
- PMID: 22810247
- DOI: 10.1212/01.CON.0000415426.76524.e1
Severe traumatic brain injury
Abstract
Purpose of review: Although adherence to traumatic brain injury (TBI) guidelines has been associated with improved patient outcomes, guideline adherence remains suboptimal in practice. With neurologists becoming increasingly involved in specialized neurointensive care units and in the care of patients with severe TBI, familiarization with these guidelines is essential.
Recent findings: Intracranial monitoring of different physiologic variables has increased in the past few years. Intracranial pressure (ICP)-driven therapy has been replaced by ICP-cerebral perfusion pressure (CPP)-driven therapy. More recently, the importance of brain oxygen optimization in addition to ICP-CPP has been recognized, and clinical trials are underway to study the effect of this approach. Surgical management of patients with TBI is also evolving rapidly with further studies on decompressive craniectomy. These are significant advances to improve TBI outcomes.
Summary: This article summarizes the routine monitoring of patients with severe TBI and offers insight into some novel physiologic monitoring devices available. The guidelines for management of patients with severe TBI are summarized along with outcome measures.
Similar articles
-
Controversies of prophylactic hypothermia and the emerging use of brain tissue oxygen tension monitoring and decompressive craniectomy in traumatic brain-injured children.Aust Crit Care. 2010 Feb;23(1):4-11. doi: 10.1016/j.aucc.2009.11.001. Epub 2009 Dec 24. Aust Crit Care. 2010. PMID: 20036140 Review.
-
Indomethacin: a review of its cerebral blood flow effects and potential use for controlling intracranial pressure in traumatic brain injury patients.Neurol Res. 1999 Jul;21(5):491-9. Neurol Res. 1999. PMID: 10439431 Review.
-
What is the optimal threshold for cerebral perfusion pressure following traumatic brain injury?Neurosurg Focus. 2003 Dec 15;15(6):E4. doi: 10.3171/foc.2003.15.6.4. Neurosurg Focus. 2003. PMID: 15305840 Review.
-
Brain tissue oxygen monitoring in pediatric patients with severe traumatic brain injury.J Neurosurg. 2006 Oct;105(4 Suppl):281-6. doi: 10.3171/ped.2006.105.4.281. J Neurosurg. 2006. PMID: 17328278
-
Spectrum of traumatic brain injury from mild to severe.Surg Clin North Am. 2012 Aug;92(4):939-57, ix. doi: 10.1016/j.suc.2012.04.005. Epub 2012 Jun 5. Surg Clin North Am. 2012. PMID: 22850156 Review.
Cited by
-
Role of Microvascular Disruption in Brain Damage from Traumatic Brain Injury.Compr Physiol. 2015 Jul 1;5(3):1147-60. doi: 10.1002/cphy.c140057. Compr Physiol. 2015. PMID: 26140712 Free PMC article. Review.
-
Combined native magnetic resonance angiography, flow-quantifying, and perfusion-imaging for impending second-stroke assessment.Quant Imaging Med Surg. 2019 Mar;9(3):521-529. doi: 10.21037/qims.2019.03.10. Quant Imaging Med Surg. 2019. PMID: 31032198 Free PMC article. Review.
-
HIF-1α involves in neuronal apoptosis after traumatic brain injury in adult rats.J Mol Neurosci. 2013 Nov;51(3):1052-62. doi: 10.1007/s12031-013-0084-7. Epub 2013 Aug 23. J Mol Neurosci. 2013. PMID: 23979836
-
The effects of hypertension on the cerebral circulation.Am J Physiol Heart Circ Physiol. 2013 Jun 15;304(12):H1598-614. doi: 10.1152/ajpheart.00490.2012. Epub 2013 Apr 12. Am J Physiol Heart Circ Physiol. 2013. PMID: 23585139 Free PMC article. Review.
-
Prehospital hypertonic saline resuscitation attenuates the activation and promotes apoptosis of neutrophils in patients with severe traumatic brain injury.Shock. 2013 Nov;40(5):366-74. doi: 10.1097/SHK.0000000000000038. Shock. 2013. PMID: 24088993 Free PMC article. Clinical Trial.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous
