Edit concept Question Editor Create issue ticket

Moderate and Severe Traumatic Cerebral Edema


Presentation

  • The pathomechanisms of brain edema and tissue injury studied in experimental models have been also presented.[books.google.com]
  • Patients typically present with a combination of reduced Glasgow Coma Scale (GCS), nausea/vomiting and/or amnesia 3.[radiopaedia.org]
  • If one or more of these signs is present, no tube should be placed by the nasal route Adapted from reference [10].[cps.ca]
  • It is the infant who presents with vomiting, lethargy or irritability who can be missed during the initial presentation.[clinicaladvisor.com]
  • The meta-analysis of ten recent studies including the present study is consonant with recent literature showing improved outcomes and reduced mortality with unilateral DC (2,28,29,40, present study).[springerplus.springeropen.com]
Hypertension
  • Much attention was drawn to the application of decompressive craniectomy in the treatment of posttr- matic intracranial hypertension. The pathomechanisms of brain edema and tissue injury studied in experimental models have been also presented.[books.google.com]
  • Stepwise approach to management of intracranial hypertension. 8.[intechopen.com]
  • Refractory intracranial hypertension and “second-tier” therapies in traumatic brain injury. Intensive Care Med 2008 ;34: 461 - 467 4. Population clock, 2011.[nejm.org]
  • Neurocrit Care 18:332–340 View Article PubMed Google Scholar Stocchetti N, Maas AIR (2014) Traumatic intracranial hypertension.[springerplus.springeropen.com]
  • The following will discuss management of intracranial hypertension and seizure occurrence.[uspharmacist.com]
Weak Pulse
  • Concussion A concussion results from a blow to the head severe enough to cause a transient or prolonged alteration of consciousness, which may be followed by amnesia, vertigo, nausea, and weak pulse.[fortherecordmag.com]
Neck Muscle Weakness
  • The effects of this abuse are worse in infants because their heads are large and their neck muscles weak. Acceleration and deceleration of the brain causes severe traumatic brain injury and may also cause cervical spine injury.[neuropathology-web.org]
Back Pain
  • As such the symptoms of which the veteran complains, should be the focus of the claim investigation, rather than the ‘post concussion syndrome’, in the same way that back pain is not a valid injury or disease, and requires the delegate to find an organic[clik.dva.gov.au]
Denial
  • The company and its representatives do not assume any responsibility for reimbursement decisions or claims denials made by providers or payers as the result of the misuse of this coding information.[fortherecordmag.com]
  • This has resulted in the blanket denial of the use of any chemical DVT prophylaxis up until more recent years, despite the common knowledge that trauma patient are at high risk for development of venous thromboembolic events.[intechopen.com]
Fear
  • The overwhelming fear associated with propagating the intracranial injury has also limited the number of studies until recently.[intechopen.com]
  • […] depression, anxiety, emotional lability (3) subjective concentration, memory, or intellectual difficulties without neuropsychological evidence of marked impairment (4) insomnia (5) reduced alcohol tolerance (6) preoccupation with the above symptoms and fear[internationalbrain.org]
Dysesthesia
  • Headache• Contralateral leg weakness• Asymmetric anterior falx• Obliterated ipsilateral frontal hornand atrium of lateral ventricle• Septum pellucidum shiftSeptumpellucidum atlevel of foramenof MonroIpsilateral ACAinfarctionTonsillar • Bilateral arm dysesthesia[slideshare.net]
Forgetful
  • […] reformation (thin slices with smallFOV)• If suspect C-spine fracture  do C-spine CT 13. www.RiTradiology.com CT in TBI: Checklist• Look at all three windowsBrain Subdural Bone 14. www.RiTradiology.com CT in TBI: Checklist• Look for primary lesions• Don’t forget[slideshare.net]
Neglect
  • PubMed Christian CW, Block R, and the Committee on Child Abuse and Neglect. Abusive Head Trauma in Infants and Children. Pediatrics 2009;123:1409â “1411. PubMed Levin AV. Retinal Hemorrhage in Abusive Head Trauma. Pediatrics 2010;126;961-970.[neuropathology-web.org]

Workup

  • An appropriate workup to evaluate GU symptoms and rule out infection is indicated. When the causes of urinary incontinence are impaired communication and mobility, a trial of a timed voiding is indicated to manage overflow incontinence.[emedicine.medscape.com]
Brain Edema
  • The pathomechanisms of brain edema and tissue injury studied in experimental models have been also presented.[books.google.com]
  • Keywords Acute Subdural Hematoma, Severe Brain Edema, Dural-Stabs, New Technique, Outcome.[alliedacademies.org]
  • Herniation (39%), intracranial rebleed (39%), and brain edema requiring osmotherapy (37%) were the three most common neurological ICU-COMPL.[escholarship.umassmed.edu]
  • Brain swelling goes by many names: Brain edema Elevated intracranial pressure Cerebral edema Swelling can occur in specific locations or throughout the brain. It depends on the cause.[webmd.com]
  • Iverson Show Summary Details Abstract and Keywords Traumatic brain injury in sports encompasses a spectrum including injuries such as concussion, skull fracture, intracranial hemorrhage, malignant brain edema syndrome, and axonal shear.[oxfordhandbooks.com]

Treatment

  • Much attention was drawn to the application of decompressive craniectomy in the treatment of posttr- matic intracranial hypertension. The pathomechanisms of brain edema and tissue injury studied in experimental models have been also presented.[books.google.com]
  • Treatment for TBI After testing, the SLP will work with you to improve your skills. What you do in treatment will depend on the problems you have.[asha.org]
  • The doctors apply the treatments according to the patient's condition.[journals.plos.org]
  • While there is limited evidence-based medicine for the treatment of TBI in children, in 2003 consensus guidelines were established for the treatment of severe TBI.[clinicaladvisor.com]
  • This may require a combination of medical and surgical treatments. Prompt treatment usually results in quicker and more complete recovery. Without it, some damage may remain.[webmd.com]

Prognosis

  • Prognosis of these patients has been different in various centers making identification and putting them in high-risk group a critical step [3].[oatext.com]
  • The results showed that naloxone could improve the patients' prognosis significantly compared with the placebo group.[journals.plos.org]
  • Treatment and prognosis Large hematomas with significant mass effect require urgent neurosurgical evacuation. Hydrocephalus can develop and urgent ventricular drainage may be required.[radiopaedia.org]
  • Prognosis in Diffuse Axonal Injury 90% of individuals with severe DAI remain in a persistent vegetative state indefinitely, and may remain so for decades.[calshipleymd.com]
  • See Traumatic Brain Injury (TBI) Prognosis References and Links CCC – Traumatic brain injury: Literature Summaries Brain Trauma Foundation Guidelines – Guidelines for the Management of Severe TBI ICN Podcast — 87.[lifeinthefastlane.com]

Etiology

  • [Crossref] Lohani S, Devkota UP (2011) Hyponatremia in patients with traumatic brain injury: etiology, incidence, and severity correlation. World Neurosurg 76: 355-360.[oatext.com]
  • In severe brain injury, more often than not there is an organic based etiology. Increased rates of personality disorder involving sensitive-compulsive individuals are often times seen. Social isolation is common.[scarlettlawgroup.com]
  • Altered mental status can be caused by infectious etiologies such as meningitis or abscesses. It can be caused by metabolic derangements such as hyperglycemia in diabetic ketoacidosis or hyperammonemia seen in liver failure.[clinicaladvisor.com]
  • Thus, hyperventilation is recommended only as a temporizing measure to reduce an elevated ICP, preferably not below 30 mmHG unless absolutely necessary and only for few minutes while determining an etiology of the intracranial hypertension and initiating[intechopen.com]
  • These imaging techniques noninvasively monitor brain function, helping to provide information on the disease etiology and can aid in making decisions about patient recovery as well as monitor responsiveness to interventions.[nap.edu]

Epidemiology

  • Epidemiology. 2011;22(6):836-844. 4. Taylor CA, Greenspan AI, Xu L, Kresnow MJ. Comparability of national estimates for traumatic brain injury-related medical encounters. J Head Trauma Rehabil. 2015;30(3): 150-159. 5.[uspharmacist.com]
  • Epidemiology and 12-month outcomes from traumatic brain injury in Australia and New Zealand. J Trauma 2008 ;64: 854 - 862 2. Murray GD, Teasdale GM, Braakman R, et al. The European Brain Injury Consortium survey of head injuries.[nejm.org]
  • Epidemiology Hospital Episode Statistics data for the 2012-2013 annual dataset indicate that there were 171,600 admissions to hospitals in England with a primary diagnosis of head injury. [ 3 ] 70% are males. 33-50% are children under 15 years of age.[patient.info]
  • Sanchez-Rodriguez Jose Juan 3, Muruato-Araiza Luis Fernando 2, Meyer Frerk 1, Kretschmer Thomas 1, Heinen Christian 1 1 Department of Neurosurgery, Evangelic Hospital Oldenburg, Medical Campus University of Oldenburg, Germany 2 Department of Clinical Epidemiology[asianjns.org]
  • Epidemiology TBI is a very serious problem in children. Approximately 500,000 children are affected in the United States alone.[clinicaladvisor.com]
Sex distribution
Age distribution

Pathophysiology

  • Therefore, patients with the same TBI severity classification may have a dramatically different pathophysiology ( Figure 254-1 ).[accessmedicine.mhmedical.com]
  • However, based on the initially proposed pathophysiological mechanism hypocalcemia could interfere with the development of cerebral edema due to neuronal death [Figure 1].[asianjns.org]
  • Siesjo BK (1992) Pathophysiology and treatment of focal ischemia. Part I: pathophysiology. J Neurosurg 77:169-184 18. Siesjo BK(1992) Pathophysiology and treatment of focal ischemia. Part II: mechanisms of damage and treatment.[ispub.com]
  • Figure 1: Proposed pathophysiological mechanism for hypocalcaemia following TBI. Figure 2: Representation at cellular level of the proposed pathophysiological mechanism after TBI in which calcium may be involved.[omicsonline.org]
  • The risk of heterotopic ossification is greatest during the first 3-4 months after injury. [32] The pathophysiology of heterotopic ossification remains unclear.[emedicine.medscape.com]

Prevention

  • Prevention Some tips can reduce the risk of a TBI. Never drink and drive.[medicalnewstoday.com]
  • Chapter 8: Prevention of seizures following traumatic brain injury. In: Sadaka F, ed. Traumatic Brain Injury.[uspharmacist.com]
  • Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem.[biau.org]
  • Prevention of growing skull fractures. J Neurosurg Pediatrics 2010;5(2):213-8.[cps.ca]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!