Neurologic Physiology: The Brain and Its Response to Injury

  • Mamerhi O. Okor
  • James M. Markert
Reference work entry

Pearls and Pitfalls

  • Early clinical recognition and radiographic diagnosis are key initial steps in the management of head injury.

  • Once a surgical lesion has been ruled out in a severely head-injured patient, aggressive medical management should be instituted. Medical management primarily constitutes supportive therapy aimed at preventing secondary insults to the brain, which should include the detection and treatment of raised intracranial pressure (ICP).

  • In the event that first-line therapy for the management of elevated ICPs is unsuccessful, “second-tier” therapy may be cautiously applied.

  • Lack of an aggressive initial approach to the head-injured patient can lead to an exacerbation of the initial injury due to potentially avoidable secondary injury – an inadequate resuscitation can lead to superimposed hypoxic or ischemic injury, and delayed institution of measures to combat increased ICP can result in increases in local tissue pressures and local ischemia, or even avoidable...

Keywords

Head Injury Glasgow Coma Scale Severe Traumatic Brain Injury Decompressive Craniectomy Glasgow Coma Scale Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Selected Readings

  1. Bullock MR, et al. (2000) Guidelines for the management of severe traumatic brain injury. American Association of Neurologic Surgeons, Joint Section on Neurotrauma and Critical Care & Traumatic Brain Trauma Foundation, New YorkGoogle Scholar
  2. Bullock MR, et al. (2006) Guidelines for the surgical management of traumatic brain injury. Neurosurgery 58(Suppl 3):S2–viGoogle Scholar
  3. Lyons MK, Meyer FB (1990) Cerebrospinal fluid physiology and the management of increased intracranial pressure. Mayo Clinic Proc 65:684–707CrossRefGoogle Scholar
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  5. Tindall GT, Cooper PR, Barrow DL (1996) The practice of neurosurgery, Vol 2. William & Wilkins, Baltimore, MD, pp 1385–1425Google Scholar
  6. Wilkins RH, Rengachary SS (eds) (1996) Neurosurgery, 2nd edn 3 vols. McGraw-Hill, New York, pp 2624–2634Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Mamerhi O. Okor
  • James M. Markert

There are no affiliations available

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