Head Injury and Neurotrauma
37th Critical Care Congress: Neurotrauma
John Myburgh, MD identifies monitoring techniques for the neurotrauma patient
Stephan A. Mayer, MD, FCCM, identifies the therapeutic controversies surrounding hypothermia
• Claudia S. Robertson, MD, FCCM discusses optimizing osmotherapy as an
option for TBI.
• Jamie Cooper, MD explains decompressive craniectomy
• Peter Reilly, MD, AO compares trauma systems & regionalization outside
the USA
To here the complete presentation, click here.
37th Critical Care Congress: Neurologic Monitoring in the PICU
• Rainer G. Gedeit, MD assesses the strengths and weaknesses of "cutting edge"
modalities to monitor the brain in the ICU
• Mark Wainwright, MD describes the current role of bedside EEG utilization in
children
• Brahm Goldstein, MD, FCCM describes potential future methods of bedside
neurologic monitoring
To hear the complete presentation, click here.
Guidelines
Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents
Pediatr Crit Care Med 2003 July;4(3):S1-S75
Supplements
Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. PCCM: July 2003, Volume 4, Issue 3
Critical Care Considerations in Pediatric Trauma (includes chapter “Critical Care Management of Head Trauma in Children”). CCM November 2002, Volume 30, Issue 11
Publications
Head and Spinal Cord Injury – 2005 Adult Multiprofessional Critical Care Review Course
The suspectibility of the spinal cord to trauma is due to a combination of its relationship to the vertebral bodies, their processes, the intervertebral disks, and the blood vessels. A patient with an anterior spinal artery infarction will lose motor strength and pain and temperature sensation below the lesion, but will typically retain proprioception. An important but overlooked critical care issue in the care of patients with spinal cord injuries is the role of the parasternal intercostal muscles in ventilation. Patients with lower cervical or upper thoracic cordlesions commonly present with adequate ventilatory parameters, but fail in a few days as they exhaust the ability of accessory muscles to compensate for the loss of the stenting action of the parasternal intercostals.
Click here to view the entire chapter; Head and Spinal Cord Injury.
For more information on caring for critically ill and injured patients, the publication Adult Multiprofessional Critical Care Review is available for purchase from the Society of Critical Care Medicine. Click here for details or to add to your shopping cart.
Acute Brain Injury: Traumatic and Atraumatic – 10th Critical Care Refresher Course
The concept of cerebral perfusion pressure (CPP) is used as a shorthand method to try to insure adequate substrate delivery at the tissue level, which is not usually measured directly. Recommendations to maintain CPP at a particular level are based in part of lowering CPP in normal subjects.
Click here to view the entire chapter; Acute Brain Injury: Traumatic and Atraumatic.
For more information on caring for critically ill and injured patients, the publication 12th Critical Care Refresher Course is available for purchase from the Society of Critical Care Medicine. Click here for details or to add to your shopping cart.
Pediatrics
Traumatic Brain and Spinal Cord Injury in Children – Pediatric Multiprofessional Critical Care Review Course.
Intracerberal hemorrhages (ICH) are collections of blood within the brain parenchyma. These are oftern the result of coalescence or progression of small hemorrhages from a cerebral contusion. Children with ICH often present with focal neurological deficits related to the location of the bleed. The bleeds can be large with mass effect and midline shift leading to altered mental level of consciousness and potential uncal herniation.
Click here to view the entire chapter; Traumatic Brian and Spinal Cord Injury in Children.
For more information on caring for critically ill and injured patients, the publication Pediatric Multiprofessional Critical Care Review Course. is available for purchase from the Society of Critical Care Medicine. Click here for details or to add to your shopping cart.
Biochemical, Cellular, and Molecular Mechanisms in the Evolution of Secondary Damage after Severe Traumatic Brain Injury in Infants and Children: Lessons Learned form the Bedside – Current Concepts in Pediatric Critical Care Course
Excitotoxixity describes the process by which glutamate and other excitatory amino acids (EAAs0 cause neuronal damage. Glutamate exposure produces neuronal injury in 2 phases. Minutes after exposure, sodium-dependent neuronal swelling occurs. This is followed by delayed calcium-dependent degeneration. Activation of specific receptors leads to calcium influx through receptor-gated or voltage gated channel, or through the release of intracellular calcium stores.
Click here to view the entire chapter; Biochemical, Cellular, and Molecular Mechanisms in the Evolution of Secondary Damage after Severe Traumatic Brain Injury in Infants and Children: Lessons Learned from the Bedside.
For more information on caring for critically ill and injured patients, the publication Current Concepts in Pediatric Critical Care Course is available for purchase from the Society of Critical Care Medicine. Click here for details or to add to your shopping cart.
SCCM Pod-79 What's New in Delirium Management
Wesley Ely, MD, FCCM, discusses new developments in delirium management, focusing on his presentation at the 36th Critical Care Congress. Dr. Ely is a professor in the department of medicine at the Vanderbilt University School of Medicine and an outcomes researcher with the Vanderbilt Center for Health Services Research. His presentation was summarized in the Congress Review, which offers education credit. Crit Conn 2007;6(3):22