By Anish Bhardwaj, Jeffrey R. Kirsch
The scientific administration of sufferers with acute mind and spinal twine harm has advanced considerably with the arrival of latest diagnostic and healing modalities. Editors Bhardwaj and Kirsch give you administration of Acute mind and Spinal twine harm, a brand new stand-alone connection with aid modern day neurologists and neurosurgeons hold abreast of all of the contemporary developments in mind and spinal twine damage. Divided into 5 sections, mind damage, ischemic stroke, intracerebral and subarachnoid hemorrhage, irritating harm and scientific administration of spinal wire accidents, this article offer you a precis of the most up-tp-date clinical technology for the scientific administration of sufferers with acute mind and spinal wire accidents.
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Additional info for Acute Brain and Spinal Cord Injury: Evolving Paradigms and Management (Neurological Disease and Therapy)
Sahuquillo J, Arikan F. Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury. Cochrane Database 2006; (1): CD003983. 39. Kunze E, Meixensberger J, Janka M, et al. Decompressive craniectomy in patients with uncontrollable intracranial hypertension. Acta Neurochir Suppl 1998; 71:16–18. 40. Albanese J, Leone M, Alliez JR, et al. Decompressive craniectomy for severe traumatic brain injury: evaluation of the effects at one year. Crit Care Med 2003; 31 (10):2535–2538.
RESCUE ICP The RESCUE ICP trial is a large, multicentered trial run collaboratively between the University of Cambridge and the European Brain Injury Consortium. Fifty patients were randomized in the pilot phase to assess the feasibility of randomization. For the primary study, 600 patients will be randomized to optimal medical management or DC. Importantly, patients may have had surgery for evacuation of a mass lesion. More specifically, the inclusion criteria will be patients who are aged 10 to 65 years with head injury and an abnormal CT scan who require ICP monitoring with raised ICP (>25 mmHg for >1–12 hours) refractory to initial medical treatment measures (48).
Licox catheters are traditionally placed in the nondominant right hemisphere or in the penumbra of the ischemic damage. PbtO2 response to an oxygen challenge test will reveal whether the Licox is accurately measuring oxygenation in viable tissue. Microdialysis Cerebral microdialysis is another tool that allows for monitoring fluctuations in markers of brain injury. Molecules in the extracellular fluid of the brain passively diffuse across a semipermeable dialysis membrane at the tip of a Cerebroprotective Strategies 29 double-lumen probe, providing a sampling of local neurochemical changes surrounding the probe.