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Punto di Riferimento
per Medici e Operatori Sanitari
per Medici e Operatori Sanitari
LIBRERIA STUDIUM
Management of Severe Traumatic Brain Injury
Sundstrøm, Grände, Juul, Kock-Jensen, Romner, Wester
Editore
Springer
Anno
2012
Pagine
417
ISBN
9783642281259
- A practical, comprehensive guide to the treatment of patients with severe head injuries, from the time of initial contact through to the rehabilitation center
- Presents evidence-based recommendations for each diagnostic and therapeutic measure Highlights tips, tricks, and pitfalls
- Includes helpful flowcharts for use in daily routine
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.
Contents
Part I Epidemiology
1 Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Snorre Sollid and Tor Ingebrigtsen
Part II Classi fi cation and Assessment
2 Classi fi cation of Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Ramona Åstrand and Bertil Romner
3 Primary Clinical Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Jacob Bertram Springborg and Vagn Eskesen
Part III Prehospital Management
4 Prehospital Management of Severe
Traumatic Brain Injury (TBI) . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Snorre Sollid
5 What the Neurosurgeon Wants to Know:
What, Who, When, and Where? . . . . . . . . . . . . . . . . . . . . . . . . . 33
Knut Wester
6 Transportation: Choice of Anaesthetic Drugs . . . . . . . . . . . . . . 37
Niels Juul
Part IV Admission, Diagnostics and Planning
7 Trauma Team Alert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Christina Rosenlund
8 The Trauma Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Christina Rosenlund
9 Trauma Protocol (ABCDE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Christina Rosenlund
10 Multi-trauma Triage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Christina Rosenlund
11 Cervical Spine Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Christina Rosenlund
12 Radiological Evaluation of Head Traumas . . . . . . . . . . . . . . . . . 55
Helle Wulf Eskildsen, Anna Tietze, and Vibeke Fink-Jensen
13 Radiological Evaluation of Cervical Spine Traumas . . . . . . . . . 63
Helle Wulf Eskildsen, Anna Tietze, and Vibeke Fink-Jensen
14 Blood Samples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Rasmus Philip Nielsen
15 Prognosis of Severe Traumatic Brain Injury:
To Treat or Not to Treat, That Is the Question . . . . . . . . . . . . . . 73
Magnus Olivecrona
16 Potential Organ Donor: Organ Preservation . . . . . . . . . . . . . . . 79
Silvana Naredi
Part V Acute Surgical Treatment
17 Basic Trauma Craniotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Terje Sundstrøm and Knut Wester
18 Surgical Management of Traumatic Intracranial
Haematomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Terje Sundstrøm and Knut Wester
19 Surgical Management of Penetrating Brain Injuries . . . . . . . . . 101
Terje Sundstrøm and Knut Wester
20 Decompressive Craniectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Pål André Rønning
21 Skull Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Pål André Rønning
22 Vessel Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Pål André Rønning
23 Insertion of Intracranial Monitoring Devices . . . . . . . . . . . . . . . 117
Mikko Kauppinen
24 Maxillofacial Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Ann Hermansson
Part VI Peroperative Anaesthesia
25 Choice of Anaesthesia Drugs and Medications . . . . . . . . . . . . . . 129
Bent Lob Dahl
26 Blood Pressure, CO2 and Oxygen Saturation . . . . . . . . . . . . . . . 133
Bent Lob Dahl
27 Intracranial Pressure Reduction . . . . . . . . . . . . . . . . . . . . . . . . . 139
Bent Lob Dahl
Part VII Monitoring in Neurointensive Care
28 Secondary Clinical Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Jacob Bertram Springborg and Vagn Eskesen
29 A Neurological Wake-Up Test in the Neurointensive
Care Unit: Pros and Cons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Niklas Marklund
30 Intracranial Pressure (ICP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Peter Reinstrup
31 Brain Tissue Oxygen Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . 165
Troels Halfeld Nielsen
32 Measurement of Brain Temperature . . . . . . . . . . . . . . . . . . . . . . 169
Peter Reinstrup and Carl-Henrik Nordström
33 Monitoring Microdialysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Peter Reinstrup and Carl-Henrik Nordström
34 Jugular Bulb Measurements (SJVO2) . . . . . . . . . . . . . . . . . . . . . 177
Bo-Michael Bellander and Peter Reinstrup
35 Cerebral Blood Flow (CBF) and
Cerebral Metabolic Rate (CMR) . . . . . . . . . . . . . . . . . . . . . . . . . 183
Peter Reinstrup and Eric L. Bloom fi eld
36 Transcranial Doppler (TCD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Peter Reinstrup, Jan Frennström, and Bertil Romner
37 Near Infrared Spectroscopy (NIRS) or Cerebral Oximetry . . . 203
Peter Reinstrup and Bertil Romner
38 Clinical Neurophysiology: Evoked Potentials . . . . . . . . . . . . . . . 207
Birger Johnsen
39 Clinical Neurophysiology: Continous EEG Monitoring . . . . . . 211
Birger Johnsen
40 Radiological Follow-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Leif Hovgaard Sørensen
41 Neuromarkers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Ramona Åstrand, Johan Undén, Peter Reinstrup,
and Bertil Romner
42 Cardiovascular Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Karen-Lise Welling
43 Pulmonary Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Jacob Koefoed-Nielsen
44 Renal Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Jens Aage Kølsen-Petersen
45 Neuroendocrine Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Marianne Klose and Ulla Feldt-Rasmussen
46 Microbiological Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Mikala Wang and Jens Kjølseth Møller
Part VIII Treatment in Neurointensive Care
47 Guidelines for Treatment of Patients with Severe
Traumatic Brain Injury: Treatment Algorithms . . . . . . . . . . . . 257
Niels Juul
48 The Lund Therapy for Severe Head Trauma . . . . . . . . . . . . . . . 263
Per-Olof Grände and Peter Reinstrup
49 Comparative Analysis of Various Guidelines
for Treatment of Severe TBI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Per-Olof Grände and Niels Juul
50 Pharmacological Neuroprotection
in Severe Traumatic Brain Injury . . . . . . . . . . . . . . . . . . . . . . . . 273
Niklas Marklund
51 Subacute Surgery in Neurointensive Care . . . . . . . . . . . . . . . . . 281
Terje Sundstrøm and Knut Wester
52 CSF Drainage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Lars-Owe D. Koskinen
53 Hyperventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Niels Juul
54 Osmotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Jens Aage Kølsen-Petersen
55 Barbiturates for ICP Management . . . . . . . . . . . . . . . . . . . . . . . 303
Mads Rasmussen
56 Fluid Haemodynamics in Patients with Severe TBI . . . . . . . . . . 307
Per-Olof Grände and Niels Juul
57 Sedation: Including Pain Treatment
and Withdrawal Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Silvana Naredi
58 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Anne Berit Guttormsen, Bram de Hoog, and Jennie Hernæs
59 Management of External Drain-Related CNS Infection . . . . . . 323
Mikala Wang and Jens Kjølseth Møller
60 Management of Other Infections . . . . . . . . . . . . . . . . . . . . . . . . . 333
Steinar Skrede
61 Body Temperature in TBI Patients . . . . . . . . . . . . . . . . . . . . . . . 339
Per-Olof Grände and Bertil Romner
62 Neuroendocrine Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343
Marianne Klose and Ulla Feldt-Rasmussen
63 Mechanical Ventilation in NICU . . . . . . . . . . . . . . . . . . . . . . . . . 347
Jacob Koefoed-Nielsen
64 Seizures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351
Elisabeth Ronne-Engström
65 Autonomic Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
Christina Rosenlund
66 Prophylaxis Against Venous Thromboembolism
in Patients with Traumatic Brain Injury . . . . . . . . . . . . . . . . . . 363
Morten Zebitz Steiness
67 Brain Injury and the Haemostatic System . . . . . . . . . . . . . . . . . 365
Martin Engström
68 Steroids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Jens Jakob Riis
Part IX Early Rehabilitation
69 Neurorehabilitation in Neurointensive Care . . . . . . . . . . . . . . . . 375
Carsten Kock-Jensen and Leanne Enggaard Langhorn
Part X Outcome After Severe TBI
70 Outcome After Severe Traumatic Brain Injury (TBI) . . . . . . . . 383
Atle Ulvik and Reidar Kvåle
71 Subacute MR Imaging: Diffuse Axonal Injury,
Brain Stem Lesions and Prognostic Factors . . . . . . . . . . . . . . . . 389
Toril Skandsen and Anne Vik
Part XI Research in the Neurointensive Care Unit
72 The Neurointensive Care Unit as a Platform
for Advanced Clinical Research . . . . . . . . . . . . . . . . . . . . . . . . . . 399
Per Enblad, Tim Howells, and Lars Hillered
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411
