Perioperative Management of Adult Patients with Severe Head Injury
Traumatic brain injury remains a significant cause of death and disability worldwide. The term severe traumatic brain injury encompasses such a heterogenous group of injuries that in itself can be difficult to define. As such, each patient warrants individual consideration based upon the mechanism of injury, neurological deficit and radiological findings. The perioperative management for severe brain injury remains broadly the same irrespective of anatomical site of injury, namely the prevention of further injury to vulnerable neighbouring neural tissue. Attention to detail, appreciation of monitoring modalities and their limitation and the current evidence base for perioperative management are integral to patient outcome and outlined in the chapter below.
KeywordsTraumatic brain injury Neuroanesthesia Critical care Intra-cranial pressure
- 2.National Institute for Health and Clinical Excellence: Guidance. Head injury: triage, assessment, investigation and early management of head injury in children, young people and adults. London: National Institute for Health and Care Excellence (UK); 2014.Google Scholar
- 15.Klose M, Juul A, Struck J, Morgenthaler NG, Kosteljanetz M, Feldt-Rasmussen U. Acute and long term pituitary insufficiency in traumatic brain injury: a prospective single centre study. Clin Endocrinol. 2007;4:598–606.Google Scholar
- 17.Carney N, Totten AM, O’Reilly C. Guidelines for the management of severe traumatic brain injury. 4th ed. Brain Trauma Foundation 2016 at: https://braintrauma.org/uploads/03/12/Guidelines_for_Management_of_Severe_TBI_4th_Edition.pdf.