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Anesthetic Care for the Post-concussive Patient: There Are More Questions Than Answers

  • Paul AuduEmail author
  • Vanessa Oforiwa Aboagye
  • Keyur Trivedi
Anesthesia for Trauma (TE Grissom, Section Editor)
Part of the following topical collections:
  1. Anesthesia for Trauma
  2. Anesthesia for Trauma

Abstract

Purpose of Review

This review informs the practicing clinician regarding the pathophysiology of mild traumatic brain injury and its implication on the anesthetic management of patients presenting for surgery. It highlights several areas where data is sparse that might spark the interest of researchers. It proposes a broad guideline for managing patients who present for surgery.

Recent Findings

The post-concussive brain has a vulnerable window of risk in which secondary insult might worsen long-term outcome. Scheduling elective surgery beyond this window of vulnerability might be beneficial. Several biomarkers may prove to be helpful in determining the timing of elective surgery and in risk stratification for the patient undergoing urgent or emergent surgery.

Summary

Mild traumatic brain injury is common. Patients often present in the acute care setting for surgical procedures unrelated to their head injury. The care of these patients may influence the natural history of their intracranial pathology and may impact long-term outcomes. In this review, we provide a brief synopsis of the pathophysiology of this disease. We discuss potential anesthetic interactions, offer broad guidelines for anesthetic management based on available data, and suggest areas of future research.

Keywords

Mild traumatic brain injury Concussion Sports-related concussion (SRC) Concussive brain injury Anesthetic management Second impact syndrome (SIS) Post-concussion syndrome (PCS) 

Notes

Compliance with Ethical Standards

Conflict of Interest

Paul Audu, Vanessa Oforiwa Aboagye, and Keyur Trivedi declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Paul Audu
    • 1
    Email author
  • Vanessa Oforiwa Aboagye
    • 2
  • Keyur Trivedi
    • 3
  1. 1.Department of AnesthesiologyCooper Medical School at Rowan UniversityCamdenUSA
  2. 2.Rowan School of Osteopathic MedicineStratfordUSA
  3. 3.Department of AnesthesiologyCooper Medical School at Rowan UniversityCamdenUSA

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