Ebook Neurotrauma and critical care of the brain (2/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Neurotrauma and critical care of the brain (2/E): Part 2
Ebook Neurotrauma and critical care of the brain (2/E): Part 2
Guidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2ctCompared with other fields of medicine, there are relatively few data guiding management of traumatic brain injury (TBI). Nonetheless, the TBI field has led in the development of evidence-based guidelines with the available literature. The TBI guidelines have become some of the most respected and Ebook Neurotrauma and critical care of the brain (2/E): Part 2adopted recommendations in medicine. Numerous guidelines for TBI have been developed, predominantly by the Brain Trauma Foundation. In addition to GuiEbook Neurotrauma and critical care of the brain (2/E): Part 2
delines for the Management of Severe TBI. additional guidelines are available specifically pertaining to pediatrics, prehospital management, prognosisGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2patients with TBI along with updates from recent key studies. Because of the difficulty inherent in studying the emergent surgical management of TBJ, many of these recommendations are consensus-based. Manage ment of epidural hematoma, subdural hematoma, intraparen-chymal hematoma, posterior fossa le Ebook Neurotrauma and critical care of the brain (2/E): Part 2sions, skull fractures, and penetrating brain injury will be discussed here. Guidelines related to decompressive hemicraniectomy will also be presenteEbook Neurotrauma and critical care of the brain (2/E): Part 2
d.Keywords: traumatic brain injury, epidural hematoma, subdural hematoma, contusion, posterior fossa lesions, depressed skull fracture, penetrating brGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2ation of pathoanatomic lesions including contusions. epidural hematoma (EDH). subdural hematoma (SDH), and others (► Table 16.1).' These lesions almost always coexist. A broad spectrum of injury severities can be seen ranging from concussion to mild, moderate, and severeTBI: severe I Bl is synonymou Ebook Neurotrauma and critical care of the brain (2/E): Part 2s with coma.Neurosurgeons play a key role in the management of TBI. Neurosurgery can be lifesaving for many patients with severe IB), and placement ofEbook Neurotrauma and critical care of the brain (2/E): Part 2
brain monitors can help optimize recovery of the brain. Neurosurgeons have led the development of TBI guidelines, and evidence demonstrates that use Guidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2al management of TBI.16.2Basics of Traumatic BrainInjury16.2.1Definition, Epidemiology, Classification, and Prognostication of Traumatic Brain InjuryTBI is defined as “an alteration in brain function, or other evidence of brain pathology, caused by an external force."’ This definition was recently a Ebook Neurotrauma and critical care of the brain (2/E): Part 2scribed as part of a consensus meeting to belter define TBI for clinical and research purposes. Alteration implies any loss or decrease in consciousneEbook Neurotrauma and critical care of the brain (2/E): Part 2
ss, any amnesia before or after the event, neurological deficits, or change in mental status. The use of imaging was also discussed as an important asGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2ting annually for 235.000 hospitalized cases for nonfatal TBI. 1.1 million patients treated in emergency departments, and 50.000 deaths in the United States alone?-5 Approximately 40 to 50% of longterm survivors demonstrate long-term disability.667 Moreover, the cumulative costs in initial care, lon Ebook Neurotrauma and critical care of the brain (2/E): Part 2g-term comorbidity, and loss in productivity account for S60 billion annually In the United States. Common causes of head injury are motor vehicle accEbook Neurotrauma and critical care of the brain (2/E): Part 2
idents (MVAs). falls, and assaults, with MVAs common in younger individuals and falls seen in the elderly? In addition. TB1 has increased in frequencyGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2chanismEpidural hematomaSubdural hematomaIntraparenchymal hematoma•Temporal bone fracture Jivj dsruplitxi of middle meningeal artery•Rupture of bridging wins JivJ extra-anal sinuses•Lacerat on of cerebral snuses (e.q.. transverse or sagctal sous)•Skul fracture burse bleeding•Rupture of bridging vems Ebook Neurotrauma and critical care of the brain (2/E): Part 2 and Intra-axlal sessefs•Parenchyma bleeding {e.g.. contusions, intracerebral hematomas)focal contusion? laceratkin. herniation. Infarction, intracranEbook Neurotrauma and critical care of the brain (2/E): Part 2
ial hematoma? delayed Intracerebral hematoma hkmfocal: edema, disseminated sweling. diffuse axonal injury‘Bruising of Use brain most common agarist boGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2Neurotrauma and Critical Care of the Brain, 2nd Ed. (ISBN 978-1 -62623-336-2).copyright © 2018 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.ManagementBecause of the challenges inherent to classifying TBI. it is most frequently classified by severit Ebook Neurotrauma and critical care of the brain (2/E): Part 2y.1 Patients with mild 1BI (postresuscitation Glasgow Coma Scale [GCS| score of 13-15) can often be managed conservatively with a period of observatioEbook Neurotrauma and critical care of the brain (2/E): Part 2
n. rhe Canadian CT Head Rules is a decision score that can aid in identifying patients with mild TB1 in whom computed tomography (CT) imaging is warraGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2kull fracture, any sign of basal skull fracture, more than two episodes of vomiting, or ago 65 years) were 100% sensitive and two medium-risk factors (amnesia before impact >30 minutes and dangerous mechanism of injury) were 98.4% sensitive for predicting need for neurological intervention. In addit Ebook Neurotrauma and critical care of the brain (2/E): Part 2ion. only 32% of patients with high-risk factors and 54% of patients with medium-risk factors would require CT imaging, suggesting that the clinical eEbook Neurotrauma and critical care of the brain (2/E): Part 2
xamination could be a powerful method to identify patients with mild TB1 that arc likely to deteriorate. Moderate TBI (GCS 9-12) and severe TBI (GCS<9Guidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2portance in the management of TBI patients: It greatly assists communication with families and helps with resource allocation and levcl-of-care decisions, focal neurological deficits commonly seen in head injury include pupillary changes, focal neurological deficits, signs of transtentorial herniati Ebook Neurotrauma and critical care of the brain (2/E): Part 2on, and seizures, which can also be important predictors of outcome. 12.12.14 ISIÕ.I7 Moreover, general predictors of good outcome include higher GCSEbook Neurotrauma and critical care of the brain (2/E): Part 2
on admission. as well as absence of transtentorial herniation, basal cistem effacement, additional intracranial lesions (e.g_. skull fractures), or wiGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstrac Ebook Neurotrauma and critical care of the brain (2/E): Part 2e Till field as it has served to definitively inform prognostic variables affecting TB1 patients. Another major achievement of this effort has been outcome prediction.1* IMPACT started 111 2003 and involved merging 11 large data sets of clinical trials and observational studies from North America an Ebook Neurotrauma and critical care of the brain (2/E): Part 2d Europe.w Multiple studies have been published from the data set. and a prognostic calculator has been developed for use in counseling patients' famiEbook Neurotrauma and critical care of the brain (2/E): Part 2
lies, evaluating trauma departments and institutions, and serving as a quality metric to improve care of TBI patients (http://www.tbi-impact.org/).16.Guidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstracGuidelines for the Surgical Manage!16 Guidelines for the Surgical Management of TraumaticBrain InjuryMichoef Korsy and Gregory W.Ị. Hff/ziy'ufcAbstracGọi ngay
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