Neurotrauma SIG, Group Information
The Neurotrauma SIG is open to all members with an interest in neurological trauma. For more information, or to get involved, contact the group chair below.
Tokutomi, T., et al. (2003). Optimal temperature for the management of severe traumatic brain injury: Effect of hypothermia on intracranial pressure, systemic and intracranial hemodynamics, and metabolism. Neurosurgery, 52(1), 102-112.
This study was performed in patients with severe traumatic brain injury (TBI) with Glasgow Coma Scale (GCS) < 6. All patients were sedated, paralyzed, ventilated and cooled to 33 degrees C. Results revealed that intracranial pressure decreased significantly at brain temperatures below 37 degrees C and decreased more sharply at temperatures 35 to 36 degrees C, but no differences were observed at temperature below 35 degrees C. For anyone looking to modify your hypothermia therapy for severe traumatic brain injury should review this article as it seems that temperatures of 35 to 35.5 degrees C seem to be optimal temperature at which to treat patients with severe TBI.
Apuzzo, MLJ. (2002). Pharmacological therapy after acute cervical spinal cord injury. Neurosurgery, 50(3), Supplement, 63-72.
Of all the articles in the supplement of Neurosurgery this topic remains the most controversial. This is again an evidenced based approach for the use of methylprednisolone in the management of acute spinal cord injury. If you are looking to change or modify you existing spinal cord injury protocol this is a must reading. In this article methylprednisolone is recommended only as an option in the treatment of patients with acute spinal cord injuries that should be undertaken with the knowledge that the evidence suggesting harmful side effects is more consistent than any suggestion of clinical benefit.
Hadley, M.N. (2002). Radiographic assessment of the cervical spine in asymptomatic trauma patients. Neurosurgery, 50(3), Supplement, 30-35.
Radiological evaluation of the cervical spine of every trauma patient is costly and results in significant radiation exposure to a large number of patients, few of whom will have a spinal injury. The purpose of this review is to define the necessary studies in asymptomatic trauma patients.
Hadley, M.N. (2002). Cervical spine immobilization before admission to the hospital. Neurosurgery, 50(3), Supplement, 7-17.
This article is one in a series of evidenced based medicine articles on Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injuries that was published in the Journal of Neurosurgery in 2002. Anyone looking to develop or consider changing pre-hospital immobilization protocols should review this article.