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This comprehensively updated second edition features major revisions, 24 new chapters and more than 40 new authors, reflecting both the advances and key challenges within the field. Offering a systematic guide to the management of children and adults with severe traumatic brain injury throughout the entire chain of care, it includes evidence-based recommendations for each diagnostic and therapeutic measure, together with tips, tricks and pitfalls. The authors are all highly experienced clinicians and researchers who work with neurotrauma patients on a daily basis, and the editors represent the Scandinavian Neurotrauma Committee. The book helps professionals provide more systematic and higher-quality care in prehospital settings, primary hospitals, neurosurgical departments, neurointensive care units, and rehabilitation facilities. It is intended for all healthcare personnel involved in the multidisciplinary management of patients with head injuries, especially those in emergency care, neurosurgery, anesthesiology, radiology, and rehabilitation.
Pathophysiological processes in brain-injured patients can be assessed with an array of methods, with a goal to identify potentially deleterious events, guide treatments and avoid further deterioration. This eBook provides an in-depth exploration into different aspects of neuro-critical care monitoring and how new tools and strategies may be utilized to improve patient outcomes.
Offers coverage on a wide range of clinical issues. There are comprehensive sections on head trauma, spinal trauma, plexus and peripheral nerve injuries, post-traumatic pain syndromes, sports and neurologic trauma, environmental trauma, posttraumatic sequelae and medicolegal aspects, and iatrogenic trauma. Among the new chapters are neurorehabilitation of brain injury, pediatric head injury, posttraumatic clinical neuropathies, neurootologic trauma and vertigo, impairment and disability evaluation, and five others on iatrogenic trauma.
Mortality and morbidity of intracerebral haemorrhage (ICH) is excessively high, and the case fatality rate has not improved in the last decades. Although surgery for ICH can be life-saving, no positive effect on functional outcome has been found in large cohorts of ICH patients. Increased understanding of the pathophysiology of ICH is needed to develop improved treatment strategies. In 17 ICH patients, paired cerebral microdialysis (CMD) catheters were inserted in the perihaemorrhagic zone (PHZ) and in normal uninjured cortex at time of surgery. Despite normalisation of cerebral blood flow, a persistent metabolic crisis indicative of mitochondrial dysfunction was detected in the PHZ. This me...
It can be reasonably anticipated that, over the next generations, the proportion of elderly people will remarkably increase and, with this, the number ofpersons suffering from acute (e.g. cerebral ischemia) or chronic neurodegenerative disorders. To date, approved drugs only alleviate the symptoms ofthese diseases (for instance, acetylcholinesterase inhibitors in Alzheimer disease and L-dopa and dopamine-agonists in Parkinson disease), while none seems to stop the progression of the degenerative processes underlying them. The development of effective preventive or protective therapies has been impeded by the limitations of our knowledge of the causes and the mechanisms by which neurons die i...
Traumatic brain injury (TBI) is a major cause of death and disability and one of the greatest unmet needs in medicine and public health. TBI not only has devastating effects on patients and their relatives but results in huge direct and indirect costs to society. Although guidelines for the management of patients have been developed and more than 200 clinical trials have been conducted, they have resulted in few improvements in clinical outcomes and no effective therapies approved for TBI. It is now apparent that the heterogeneity of clinical TBI is underlain by molecular phenotypes more complex and interactive than initially conceived and current approaches to the characterization, manageme...
This Research Topic surrounds the information presented at the upcoming conference Neurotrama Symposium held at the Centre for Trauma Research, September 15-16 2010. Traumatic injury to the central nervous system (CNS) is the leading cause of death and disability for people up to about 40 years of age. Examples and experiences of CNS trauma and medical care during historic and ongoing wars will be given, referring to the early history of Karolinska Institutet (KI).
In order to reduce the number of deaths from severe head injuries, systematic management is essential. This book is a practical, comprehensive guide to the treatment of patients (both adults and children) with such injuries, from the time of initial contact through to the rehabilitation center. Sections are devoted to prehospital treatment, admission and diagnostics, acute management, and neurointensive care and rehabilitation. Evidence-based recommendations are presented for each diagnostic and therapeutic measure, and tips, tricks, and pitfalls are highlighted. Throughout, the emphasis is on the provision of sound clinical advice that will maximize the likelihood of an optimal outcome. Helpful flowcharts designed for use in daily routine are also provided. The authors are all members of the Scandinavian Neurotrauma Committee and have extensive practical experience in the areas they write about.
This book provides a comprehensive analysis of the contemporary management of all aspects of traumatic brain injury (TBI), combining the findings of several recent randomised controlled trials investigating the role of hypothermia, erythropoietin, intracranial pressure monitoring and decompressive craniectomy in the management of TBI. The book is divided into four sections: the first section covers the epidemiology of TBI, the changing global patterns of presentation, and the basic pathophysiology and classification, while the second discusses contemporary management of TBI, from pre-hospital care, emergency assessment, and medical and surgical management to rehabilitation and social reinteg...