Traumatic brain injury (TBI) is a worldwide major cause of morbidity and mortality particularly in the vulnerable population young males, low-income individuals and members of ethnic minority groups.
Severe traumatic brain injury, defined as head trauma associated with a Glasgow Coma Scale (GCS) score of 3 to 8 with loss of consciousness duration and altered mental status greater than 24 hours and post traumatic amnesia more than seven days.
In this resume of protocols article, a helpful review of the current status of management of severe TBI according to the recent up-dated brain trauma foundation 2016 and The National Institute for Health and Care Excellence (NICE) 2014 guidelines is present. A concise overview of the optimal medical management, and both the non-invasive and invasive monitoring strategies, as well as the indications of surgical interventions necessary in particular instances. It is important not only for trauma team but for all healthcare personnel to be aware of the management and prevention of complications of severe traumatic brain injury.
Hyder A, Wunderlich C, Puvanachandra P, Gururaj G, Kobusingye
O. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation 2007; 22:341-53.
Kamal VK, Agrawal D, Pandey RM. Epidemiology, clinical characteristics and outcomes of traumatic brain injury: evidences from integrated level 1 trauma center in India. J Neurosci Rural Pract 2016; 7:515-25.
Fleminger S, Ponsford J. Long term outcome after traumatic brain injury. BMJ 2005; 331:1419-20.
De ramirez SS, Hyder AA, Herbert HK, Stevens K. Unintentional injuries: magnitude, prevention, and control. Annu Rev Public Health 2012; 33:175-91.
Kraus JF, Black MA, Hessol N, Ley P, Rokaw W, Sullivan C, et al. The incidence of acute brain injury and serious impairment in a defined population. Am J Epidemiol 1984; 119:186-201.
Tieves K, Yang H, Layde P. The epidemiology of traumatic brain injury in Wisconsin, 2001. WMJ 2005; 104:22-5.
Dawodu, ST. 2017. Traumatic brain injury: Definition, epidemiology, pathophysiology, Available from: http://www.emedicine.com/pmr/ topic212.htm (Last access 03/04/2019).
Management of Concussion/mTBI Working Group. VA/DoD clinical practice guideline for management of concussion/mild traumatic brain injury. J Rehabil Res Dev 2009; 46:CP1-68.
Frey LC. Epidemiology of posttraumatic epilepsy: A critical review. Epilepsia 2003; 44(s10):11-7.
Jallo JI, Narayan RK. Craniocerebral trauma. In: WG Bradley, RB Daroff, GM Fenichel, et al. Eds. Neurology in clinical practice. Boston: Butterworth-Heinemann 2000; 1055-87.
Maegele M, Engel D, Bouillon B, Lefering R, Fach H, Raum M, et al. Incidence and outcome of traumatic brain injury in an urban area in Western Europe over 10 years. Eur Surg Res 2017; 39:372-9.
Jennett B. Epidemiology of head injury. J Neurol Neurosurg Psychiatry 1996; 60:362-9.
Hodgkinson S, Pollit V, Sharpin C, Lecky F. Early management of head injury: summary of updated NICE guidance. BMJ 2014; 348:g104.
Gossman W, Plantz S. Pearls of Wisdom Emergency Medicine. 5th ed. New York: McGraw-Hill; 2008.
Hall JB, Shmidt GA, Kress JP. Intracranial pressure: monitoring and management. In Principles of critical care. 4th ed. New York: McGraw- Hill 2015; 786-820.
Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017; 80:6-15.
Department of surgical education. Antiplatelet agent reversal in adults with traumatic intracranial hemorrhage. Available from: http:// www.surgicalcriticalcare.net/Guidelines/Antiplatelet%20Reversal%20 Guideline.pdf (Last access 03/04/2019).
Cremer OL, Moons KG, Bouman EA, Kruijswijk JE, de Smet AM, Kalkman CJ. Long-term propofol infusion and cardiac failure in adult head-injured patients. Lancet 2001; 357:117-8.
Stevens R, Shoykhet M, Cadena R. Emergency Neurological Life Support: Intracranial hypertension and herniation. Neurocrit Care 2015; 23 (s2):S76-82.
Brown A, Codigan M. Emergency medicine diagnosis and management 7th ed. CRC Press; 2016.
Nazir M, Khan S, Raja R, Bhatti S, Ahmed E. Cervical spinal injuries in moderate to severe head injuries. J Ayub Med Coll Abbottabad 2012; 24:100-2.
Bullock M, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell D, et al. Surgical management of acute epidural hematomas. Neurosurgery 2006; 58:S7-15.
Bullock M, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell D, et al. Surgical management of acute subdural hematomas. Neurosurgery 2006; 58:S16-24.
Youmans J. Neurological surgery: A comprehensive reference guide to the diagnosis and management of neurosurgical problems. 4th ed. Philadelphia Saunders; 1996.
Rabinovici R, Frankel HL, Kirton O. Trauma, critical care and surgical emergencies. 1st ed. Informa UK; 2010.
Bullock M, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell D, et al. Surgical management of traumatic parenchymal lesions. Neurosurgery 2006; 58:S23-46.
Feldman Z, Kanter M, Robertson C, Contant C, Hayes C, Sheinberg M, et al. Effect of head elevation on intracranial pressure, cerebral perfusion pressure, and cerebral blood flow in head injured patients. J Neurosurg 1992; 76:207-11.
Frontera J, Lewin J, Rabinstein A, Aisiku I, Alexandrov A, Cook A, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage. Neurocrit Care 2016; 24:6-46.
Ranucci M, Nano G, Pazzaglia A, Bianchi P, Casana R, Tealdi DG. Platelet mapping and desmopressin reversal of platelet inhibition during emergency carotid endarterectomy. J CardothoracVasc Anesth 2007; 21:851-4.
Floradal PA, Sahlin S. Use of desmopressin to prevent bleeding complications in patients treated with aspirin. Br J Surg 1993; 80:723-4.
Department of surgical education. Antiplatelet agent reversal in adults with traumatic intracranial hemorrhage. Available from: http:// www.surgicalcriticalcare.net/Guidelines/Antiplatelet%20Reversal%20 Guideline.pdf (Last access 17/04/2019).
Hedges SJ, Dehoney SB, Hooper JS, Amanzadeh J, Busti AJ. Evidence- based treatment recommendations for uremic bleeding. Nature Clin Prac 2007; 3:138-53.
Voils S. Pharmacologic interventions for the management of critical bleeding. Pharmacotherapy 2007; 27:69S-84S.
Prexl O, Bruckbauer M, Voelckel W, Grottke O, Ponschab M, Maegele M, et al. The impact of direct oral anticoagulants in traumatic brain injury patients greater than 60-years-old. Scand J Trauma Resusc Emerg Med 2018; 26:20.
Zangbar B, Pandit V, Rhee P, Khalil M, Kulvatunyou N, O’Keeffe T, Tang A, et al. Clinical outcomes in patients on preinjury ibuprofen with traumatic brain injury. Am J Surg 2014; 209:921-6.
Thompson H, Kirkness C, Mitchell P. Intensive care unit management of fever following traumatic brain injury. Intensive Crit Care Nurs 2007; 23:91-6.
Holtzclaw BJ. Use of thermoregulatory principles in patient care: Fever management. The Online Journal of Clinical Innovations 2002; 5:1-64.
Ekeh AP, Dominguez K, Markert R, McCarthy M. Incidence and risk factors for deep venous thrombosis after moderate and severe brain injury. J Trauma 2010; 68:912-5.
Prabhakar H, Sandhu K, Bhagat H, Durga P,Chawla R. Current concepts of optimal cerebral perfusion pressure in traumatic brain injury. J Anaesthesiol Clin Pharmacol 2014; 30:318-27.
Laskowitz D, Grant G. Translational research in traumatic brain injury. boca raton (FL): CRC Press/Taylor and Francis Group; 2016.
LIorente G, Mejia MC. Mannitol versus hypertonic saline solution in neuroanaesthesia. Rev Colomb Anestesiol 2015; 43:29-39.
Brain Trauma Foundation; American association of neurological surgeons; Congress of neurological surgeons; Joint section on neurotrauma and critical care, AANS/CNS, Carney NA, Ghajar J. Guidelines for the management of severe traumatic brain injury. J Neurotrauma 2007; 24:S1-106.
Giardino N, Friedman S, Dager S. Anxiety, respiration, and cerebral blood flow: implications for functional brain imaging. Compr Psychiatry 2007; 48:103-12.
Eisenberg HM, Frankowski RF, Contant CF, Marshall LF, Walker MD. High dose barbiturates control of elevated intracranial pressure in patients with severe TBI. J Neurosurgery 1988; 69;15-23.
Haddad S, Arabi Y. Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med 2012; 20:12.
Bersten A. Oh’s intensive care manual. 7th ed. Butterworth Heinmann
Bullock MR, Chesnut R, Gghagar J, Gordon D, Hartl R, Newell DW, et al. Surgical management of depressed cranial fractures. Neurosurgery 2006; 58:S56-60.
Moon JW, Hyun DK. Decompressive craniectomy in traumatic brain injury: A review article. Korean J Neurotrauma 2017; 13:1-8.
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 2:81-4.
Teasdale GM, Pettigrew LE, Wilson JT, Murray G, Jennett B. Analyzing outcome of treatment of severe head injury: A review and update on advancing the use of the Glasgow Outcome Scale. J Neurotrauma 1998; 15:587-97.
Wilson JTL, Pettigrew LE, Teasdale GM. Structured interviews for the Glasgow outcome scale and the extended glasgow outcome Scale: Guidelines for their use. J Neurotrauma 1997; 15:573-85.
Deepika A, Prabhuraj AR, Saikia A, Shukla D. Comparison of predictability of Marshall and Rotterdam CT-scan scoring system in determining early mortality after traumatic brain injury. Acta Neurochir (Wien) 2015; 157:2033-8.
Yokota H, Naoe Y, Nakabayashi M, Unimito K, Kashimoto S. Cerebral endothelial injury in severe head injury: the significance of measurement of serum thrombomodulin and von vellibrand factor. J Neurotrauma 2002; 19;1007-15.
Mercier E, Boutin A, Lauzier F, Fergusson D, Simard JF, Zarychanski R, et al. Predictive value of S-100β protein for prognosis in patients with moderate and severe traumatic brain injury: systematic review and meta- analysis. BMJ 2013; 346:f1757.
Cairns CJ, Andrews PJ. Management of hyperthermia in traumatic brain injury. Curr Opin Crit Care 2002; 8:106-10.
Ayling, J. Managing head injuries. Emerg Med Serv 2002; 31:42.