PMID: 11310289Apr 20, 2001Paper

Management of closed head injury

Revista de neurologia
J I Suárez

Abstract

To review current concepts regarding the management of severe closed head injury and determine the possible causes of brain damage in these patients. Severe closed head injury causes a high rate of mortality and disability in developed countries. The diagnosis and management of these patients has progressed in recent years, from the availability of brain scanning to varied therapeutic methods based on brain metabolism and intracranial dynamics. We have reviewed the different neuropathological processes in relation to closed head injury and emphasized the importance of recognition and control of the secondary lesions, which may have disastrous consequences for the patient. After clinical evaluation and early cardiorespiratory stabilization, the patients are taken to a critical care unit for continuous monitoring of the intracranial pressure, cerebral perfusion pressure and cerebral extraction of oxygen. We have discussed several therapeutic interventions taking into account the values obtained by continuous monitoring of these patients. As well as traditional measures (hyperventilation, manitol and barbiturate coma), there are other possibilities for treatment of these patients such as hypothermia, hypertonic saline solutions an...Continue Reading

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