TY - JOUR
T1 - Pathophysiology and Management of Intracranial Hypertension and Tissular Brain Hypoxia After Severe Traumatic Brain Injury
T2 - An Integrative Approach
AU - Godoy, Daniel Agustín
AU - Lubillo, Santiago
AU - Rabinstein, Alejandro A.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/4
Y1 - 2018/4
N2 - Monitoring intracranial pressure in comatose patients with severe traumatic brain injury (TBI) is considered necessary by most experts. Acute intracranial hypertension (IHT), when severe and sustained, is a life-threatening complication that demands emergency treatment. Yet, secondary anoxic-ischemic injury after brain trauma can occur in the absence of IHT. In such cases, adding other monitoring modalities can alert clinicians when the patient is in a state of energy failure. This article reviews the mechanisms, diagnosis, and treatment of IHT and brain hypoxia after TBI, emphasizing the need to develop a physiologically integrative approach to the management of these complex situations.
AB - Monitoring intracranial pressure in comatose patients with severe traumatic brain injury (TBI) is considered necessary by most experts. Acute intracranial hypertension (IHT), when severe and sustained, is a life-threatening complication that demands emergency treatment. Yet, secondary anoxic-ischemic injury after brain trauma can occur in the absence of IHT. In such cases, adding other monitoring modalities can alert clinicians when the patient is in a state of energy failure. This article reviews the mechanisms, diagnosis, and treatment of IHT and brain hypoxia after TBI, emphasizing the need to develop a physiologically integrative approach to the management of these complex situations.
KW - Acute brain injury
KW - Brain hypoxia
KW - Cerebral oxygenation
KW - Cerebral perfusion pressure
KW - Intracranial hypertension
KW - Intracranial pressure
KW - Multimodal monitoring
KW - Traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85042743839&partnerID=8YFLogxK
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U2 - 10.1016/j.nec.2017.12.001
DO - 10.1016/j.nec.2017.12.001
M3 - Review article
C2 - 29502711
AN - SCOPUS:85042743839
SN - 1042-3680
VL - 29
SP - 195
EP - 212
JO - Neurosurgery clinics of North America
JF - Neurosurgery clinics of North America
IS - 2
ER -