Medical Management of the Severe Traumatic Brain Injury Patient

Jonathan Marehbian, Susanne Muehlschlegel, Brian L. Edlow, Holly E. Hinson, David Y. Hwang

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Severe traumatic brain injury (sTBI) is a major contributor to long-term disability and a leading cause of death worldwide. Medical management of the sTBI patient, beginning with prehospital triage, is aimed at preventing secondary brain injury. This review discusses prehospital and emergency department management of sTBI, as well as aspects of TBI management in the intensive care unit where advances have been made in the past decade. Areas of emphasis include intracranial pressure management, neuromonitoring, management of paroxysmal sympathetic hyperactivity, neuroprotective strategies, prognostication, and communication with families about goals of care. Where appropriate, differences between the third and fourth editions of the Brain Trauma Foundation guidelines for the management of severe traumatic brain injury are highlighted.

Original languageEnglish (US)
Pages (from-to)430-446
Number of pages17
JournalNeurocritical Care
Volume27
Issue number3
DOIs
StatePublished - Dec 1 2017

Keywords

  • Brain injuries, traumatic
  • Critical care
  • Decision-making
  • Intracranial pressure
  • Neuroimaging
  • Prognosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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