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Traumatic brain injury 

Traumatic brain injury
Chapter:
Traumatic brain injury
Author(s):

Lisa A. DelSignore

DOI:
10.1093/med/9780198794592.003.0007
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date: 27 July 2021

Chapter 7 covers the definition, epidemiology, pathophysiology, and management of traumatic brain injury (TBI). It explains the fundamental concepts of brain physiology: intracranial compliance; intracranial hypertension; cerebral perfusion pressure; cerebral blood flow; and autoregulation. Medical management of TBI is detailed, including hyperosmolar therapy and nutritional support. Neuromonitoring of patients with TBI in the intensive care unit is discussed, including the evidence base for seizure monitoring and antiepileptic drug prophylaxis. Patients with severe TBI and refractory intracranial hypertension may need escalation to second-tier therapies, which are evaluated, including the evidence for decompressive craniectomy. A concise summary of the different therapies is included.

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