Acute Brain and Spinal Cord Injury: Evolving Paradigms and by Anish Bhardwaj, Jeffrey R. Kirsch PDF
By Anish Bhardwaj, Jeffrey R. Kirsch
The medical administration of sufferers with acute mind and spinal wire damage has developed considerably with the arrival of latest diagnostic and healing modalities. Editors Bhardwaj, Ellegala, and Kirsch current Acute mind and Spinal twine Injury , a brand new stand-alone connection with aid todayвЂ™s neurologists and neurosurgeons retain abreast of the entire fresh developments in mind and spinal twine harm. Divided into 5 sections, annoying mind harm, ischemic stroke, intracerebral and subarachnoid hemorrhage, and spinal wire damage, this article bargains the most up-tp-date scientific technological know-how and highlights controversies within the medical administration of sufferers with acute mind and spinal wire injuries.
Acute mind and Spinal wire Injury :
- each part delineates diagnostic and tracking instruments, pharmacotherapies, and interventional and surgical remedies are covered
- examines and explores lately released laboratory trials and research
- incorporates over 50 diagrams and figures for concise conversation of medical information
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Extra info for Acute Brain and Spinal Cord Injury: Evolving Paradigms and Management
3). The lower margin of the craniectomy determines the extent of mesencephalic cisternal decompression (32). Bilateral injury or diffuse cerebral edema, as in cases of diffuse axonal injury, is managed with bilateral decompression in varying forms. In his seminal work, Kjellberg described the procedure that now bears his name, the most Figure 3 A unilateral hemicraniectomy is shown, with anterior temporal decompression indicated by the dotted line. 5 cm above the transverse and sigmoid sinuses.
17 18 Shankar et al. of patients with severe TBI are reviewed. The classifications and assessment of severe TBI, appropriate management strategies to avoid intracranial hypertension and cerebral ischemia, and overall medical optimization and possibilities for novel neuroprotective strategies are discussed. INITIAL NEUROLOGIC ASSESSMENT Glasgow Coma Scale Score The examination begins with a careful assessment for external head trauma. The neurologic examination is characterized by the Glasgow Coma Scale (GCS) score (Table 1).
The DECRA study is also a multicentered, randomized trial that involves centers in New Zealand and Australia and is based at the Alfred Hospital in Melbourne (42). This study aims to enroll fewer patients—200—but has similar primary end points as the RESCUEicp trial. The secondary end points, including ICP control, are similar but also include measurement of brain metabolites in patients treated at the Alfred Hospital. CONCLUSION AND FUTURE DIRECTIONS We have reviewed the rationale, technique, and evidence regarding the use of DC in patients with TBI, the future of which rests with the results of ongoing clinical trials.
Acute Brain and Spinal Cord Injury: Evolving Paradigms and Management by Anish Bhardwaj, Jeffrey R. Kirsch