Can Secondary Brain Damage be Prevented by Pharmacological or other Means?
Modern treatment of severe brain injury has centered on the hospital phase with neurosurgeons and others providing intensive care devoting much of their attention to the treatment of intracranial hypertension. This is appropriate since approximately 55% of severely head injured patients reaching the hospital alive will have an ICP in excess of 30 mmHg at some time during their intensive care. However, it is important to recognize that treatment of secondary insults to the already injured brain can not only reduce the number of patients who die prior to hospitalization, but may also reduce the incidence of elevated ICP, the most frequent cause of death in the severely head injured. Harr et al., have shown that severe hypoxia in the pre-hospital phase was associated with a substantially increased risk of elevated ICP during hospitalization (1). One might therefore conclude that early treatment of hypoxia should reduce the incidence of intracranial pressure rises and thus decrease mortality.
KeywordsIntracranial Hypertension Cerebral Vasospasm Severe Head Injury Acute Brain Injury Severe Brain Injury
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