Skip to main content
SpringerLink
Log in
Book cover

Trauma Surgery pp 165–181Cite as

Acute Traumatic Brain Injuries and Their Management

  • Chapter
  • First Online:

  • 2866 Accesses

Abstract

Traumatic brain injuries (TBIs) represent the leading cause of death and morbidity in western countries. Since motor vehicle accidents are the leading cause of significant trauma, TBIs affect mostly young adults with increasing incidence and are responsible for a major social and economic burden. For decades, the mainstay of neurotrauma management has been represented by control of posttraumatic edema and raised intracranial pressure (ICP). With the emergence of a better understanding of the underlying cellular mechanisms responsible for the generation of secondary brain damage, the hope for the “magic bullet” has prompted the development of novel drugs. Encouraged by the promising results of basic research studies, clinical trials were initiated in an increasing number up to the mid-1990s. However, the high expectations raised by convincing laboratory data were not met by deceiving results that made pharmaceutical industry reluctant to support high-cost adventurous research that have repeatedly failed to significantly improve outcome of head-injured patients. Accordingly, the management of neurotrauma has focused back on optimization of neurointensive care and surgical treatment.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Doppenberg EM, Choi SC, Bullock R (2004) Clinical trials in traumatic brain injury: lessons for the future. J Neurosurg Anesthesiol 16(1):87–94

    Article  PubMed  Google Scholar 

  2. Coronado VG, Xu L (2011) Surveillance for traumatic brain injury-related deaths: United States, 1997–2007. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, p 32

    Google Scholar 

  3. Gennarelli TA (1983) Head injury in man and experimental animals: clinical aspects. Acta Neurochir Suppl (Wien) 32:1–13

    Article  CAS  Google Scholar 

  4. Treggiari MM, Schutz N, Yanez ND, Romand JA (2007) Role of intracranial pressure values and patterns in predicting outcome in traumatic brain injury: a systematic review. Neurocrit Care 6(2):104–112

    Article  PubMed  Google Scholar 

  5. Simon RP, Griffiths T, Evans MC, Swan JH, Meldrum BS (1984) Calcium overload in selectively vulnerable neurons of the hippocampus during and after ischemia: an electron microscopy study in the rat. J Cereb Blood Flow Metab 4(3):350–361

    Article  CAS  PubMed  Google Scholar 

  6. Jaggi JL, Obrist WD, Gennarelli TA, Langfitt TW (1990) Relationship of early cerebral blood flow and metabolism to outcome in acute head injury. J Neurosurg 72(2295915):176–182

    Article  CAS  PubMed  Google Scholar 

  7. Robertson CS, Gopinath SP, Goodman JC, Contant CF, Valadka AB, Narayan RK (1995) SjvO2 monitoring in head-injured patients. J Neurotrauma 12(5):891–896

    Article  CAS  PubMed  Google Scholar 

  8. Martin NA, Patwardhan RV, Alexander MJ, Africk CZ, Lee JH, Shalmon E, Hovda DA, Becker DP (1997) Characterization of cerebral hemodynamic phases following severe head trauma: hypoperfusion, hyperemia, and vasospasm. J Neurosurg 87(9202259):9–19

    Article  CAS  PubMed  Google Scholar 

  9. Soustiel JF, Glenn TC, Shik V, Boscardin J, Mahamid E, Zaaroor M (2005) Monitoring of cerebral blood flow and metabolism in traumatic brain injury. J Neurotrauma 22(9):955–965

    Article  PubMed  Google Scholar 

  10. Vespa P, Bergsneider M, Hattori N, Wu HM, Huang SC, Martin NA, Glenn TC, McArthur DL, Hovda DA (2005) Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study. J Cereb Blood Flow Metab 25(6):763–774

    Article  CAS  PubMed  Google Scholar 

  11. Soustiel JF, Vlodavsky E, Milman F, Gavish M, Zaaroor M (2011) Improvement of cerebral metabolism mediated by Ro5-4864 is associated with relief of intracranial pressure and mitochondrial protective effect in experimental brain injury. Pharm Res 28(11):2945–2953

    Article  CAS  PubMed  Google Scholar 

  12. Bratton SL, Chestnut RM, Ghajar J, McConnell Hammond FF, Harris OA, Hartl R, Manley GT, Nemecek A, Newell DW, Rosenthal G, Schouten J, Shutter L, Timmons SD, Ullman JS, Videtta W, Wilberger JE, Wright DW (2007) Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds. J Neurotrauma 24 Suppl 1:S55–S58

    PubMed  Google Scholar 

  13. Barmparas G, Singer M, Ley E, Chung R, Malinoski D, Margulies D, Salim A, Bukur M (2012) Decreased intracranial pressure monitor use at level II trauma centers is associated with increased mortality. Am Surg 78(10):1166–1171

    PubMed  Google Scholar 

  14. Coles JP, Minhas PS, Fryer TD, Smielewski P, Aigbirihio F, Donovan T, Downey SP, Williams G, Chatfield D, Matthews JC, Gupta AK, Carpenter TA, Clark JC, Pickard JD, Menon DK (2002) Effect of hyperventilation on cerebral blood flow in traumatic head injury: clinical relevance and monitoring correlates. Crit Care Med 30(9):1950–1959

    Article  CAS  PubMed  Google Scholar 

  15. Muizelaar JP, Marmarou A, Ward JD, Kontos HA, Choi SC, Becker DP, Gruemer H, Young HF (1991) Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial. J Neurosurg 75(5):731–739

    Article  CAS  PubMed  Google Scholar 

  16. Haddad SH, Arabi YM (2012) Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med 20:12

    Article  PubMed Central  PubMed  Google Scholar 

  17. Kamel H, Navi BB, Nakagawa K, Hemphill JC 3rd, Ko NU (2011) Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials. Crit Care Med 39(3):554–559

    Article  CAS  PubMed  Google Scholar 

  18. Oddo M, Levine JM, Frangos S, Carrera E, Maloney-Wilensky E, Pascual JL, Kofke WA, Mayer SA, LeRoux PD (2009) Effect of mannitol and hypertonic saline on cerebral oxygenation in patients with severe traumatic brain injury and refractory intracranial hypertension. J Neurol Neurosurg Psychiatry 80(8):916–920

    Article  CAS  PubMed  Google Scholar 

  19. Cottenceau V, Masson F, Mahamid E, Petit L, Shik V, Sztark F, Zaaroor M, Soustiel JF (2011) Comparison of effects of equiosmolar doses of mannitol and hypertonic saline on cerebral blood flow and metabolism in traumatic brain injury. J Neurotrauma 28(10):2003–2012

    Article  PubMed  Google Scholar 

  20. Rosner MJ, Daughton S (1990) Cerebral perfusion pressure management in head injury. J Trauma 30(8):933–940; discussion 940–941

    Article  CAS  PubMed  Google Scholar 

  21. Robertson CS, Valadka AB, Hannay HJ, Contant CF, Gopinath SP, Cormio M, Uzura M, Grossman RG (1999) Prevention of secondary ischemic insults after severe head injury. Crit Care Med 27(10):2086–2095

    Article  CAS  PubMed  Google Scholar 

  22. Solomonov E, Hirsh M, Yahiya A, Krausz MM (2000) The effect of vigorous fluid resuscitation in uncontrolled hemorrhagic shock after massive splenic injury. Crit Care Med 28(3):749–754

    Article  CAS  PubMed  Google Scholar 

  23. Henderson WR, Dhingra VK, Chittock DR, Fenwick JC, Ronco JJ (2003) Hypothermia in the management of traumatic brain injury. A systematic review and meta-analysis. Intensive Care Med 29(10):1637–1644

    Article  PubMed  Google Scholar 

  24. Roberts I, Yates D, Sandercock P, Farrell B, Wasserberg J, Lomas G, Cottingham R, Svoboda P, Brayley N, Mazairac G, Laloe V, Munoz-Sanchez A, Arango M, Hartzenberg B, Khamis H, Yutthakasemsunt S, Komolafe E, Olldashi F, Yadav Y, Murillo-Cabezas F, Shakur H, Edwards P (2004) Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet 364(9442):1321–1328

    Article  PubMed  Google Scholar 

  25. Zacko JC, Harris L, Bullock MR (2011) Surgical management of traumatic brain injury. In: Win HR (ed) Youmans neurological surgery, vol 4. Elsevier Saunders, Philadelphia, pp 3424–3452

    Chapter  Google Scholar 

  26. Lobato RD, Cordobes F, Rivas JJ, de la Fuente M, Montero A, Barcena A, Perez C, Cabrera A, Lamas E (1983) Outcome from severe head injury related to the type of intracranial lesion. A computerized tomography study. J Neurosurg 59(5):762–774

    Article  CAS  PubMed  Google Scholar 

  27. Servadei F, Nanni A, Nasi MT, Zappi D, Vergoni G, Giuliani G, Arista A (1995) Evolving brain lesions in the first 12 hours after head injury: analysis of 37 comatose patients. Neurosurgery 37(5):899–906; discussion 906–907

    Article  CAS  PubMed  Google Scholar 

  28. Compagnone C, Murray GD, Teasdale GM, Maas AI, Esposito D, Princi P, D’Avella D, Servadei F (2005) The management of patients with intradural post-traumatic mass lesions: a multicenter survey of current approaches to surgical management in 729 patients coordinated by the European Brain Injury Consortium. Neurosurgery 57(6):1183–1192; discussion 1183–1192

    Article  PubMed  Google Scholar 

  29. Sahuquillo J, Arikan F (2006) Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury. Cochrane Database Syst Rev (1):CD003983

    Google Scholar 

  30. Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, D’Urso P, Kossmann T, Ponsford J, Seppelt I, Reilly P, Wolfe R (2011) Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 364(16):1493–1502

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Shock and Trauma Research Laboratory, Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel

    Michael M. Krausz MD

  2. Department of Surgery B, Hillel Yaffe Medical Center, 169, Hadera, 38100, Israel

    Michael M. Krausz MD & Itamar Ashkenazi MD

  3. Acute Brain Injury Research Laboratory, Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel

    Itamar Ashkenazi MD

  4. Department of Neurosurgery, Western Galilee Medical Center, Naharia, Israel

    Jean F. Soustiel MD

Authors
  1. Michael M. Krausz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Itamar Ashkenazi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean F. Soustiel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael M. Krausz MD .

Editor information

Editors and Affiliations

  1. Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy

    S. Di Saverio

  2. Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy

    G. Tugnoli

  3. Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy

    F. Catena

  4. General and Emergency Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    L. Ansaloni

  5. Department of Surgery, Port Shepstone Regional Hospital, Durban, South Africa

    N. Naidoo

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Krausz, M.M., Ashkenazi, I., Soustiel, J.F. (2014). Acute Traumatic Brain Injuries and Their Management. In: Di Saverio, S., Tugnoli, G., Catena, F., Ansaloni, L., Naidoo, N. (eds) Trauma Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5403-5_12

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5403-5_12

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5402-8

  • Online ISBN: 978-88-470-5403-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation