Clinical Management in Traumatic Brain Injury

Abstract

Traumatic brain injury is one of the leading causes of morbidity and mortality worldwide and is one of the major public healthcare burdens in the US, with millions of patients suffering from the traumatic brain injury itself (approximately 1.6 million/year) or its repercussions (2–6 million patients with disabilities). The severity of traumatic brain injury can range from mild transient neurological dysfunction or impairment to severe profound disability that leaves patients completely non-functional. Indications for treatment differ based on the injury’s severity, but one of the goals of early treatment is to prevent secondary brain injury. Hemodynamic stability, monitoring and treatment of intracranial pressure, maintenance of cerebral perfusion pressure, support of adequate oxygenation and ventilation, administration of hyperosmolar agents and/or sedatives, nutritional support, and seizure prophylaxis are the mainstays of medical treatment for severe traumatic brain injury. Surgical management options include decompressive craniectomy or cerebrospinal fluid drainage via the insertion of an external ventricular drain. Several emerging treatment modalities are being investigated, such as anti-excitotoxic agents, anti-ischemic and cerebral dysregulation agents, S100B protein, erythropoietin, endogenous neuroprotectors, anti-inflammatory agents, and stem cell and neuronal restoration agents, among others.

A Prospective Longitudinal Cohort Study of Serum Stanniocalcin-1 as a Potential Prognostic Biomarker of Severe Traumatic Brain Injury

“… 1 Road traffic accident is the primary cause of TBI, followed by falls. 2 One-third to half of trauma-related deaths are primarily caused by TBI, affecting 15–20/100,000 individuals annually. 2 Severe TBI (sTBI) accounts for 8% of all TBI worldwide, with approximately 5.48 million people suffering from sTBI annually.…”

“… 2 One-third to half of trauma-related deaths are primarily caused by TBI, affecting 15–20/100,000 individuals annually. 2 Severe TBI (sTBI) accounts for 8% of all TBI worldwide, with approximately 5.48 million people suffering from sTBI annually. 3 sTBI mortality is from 20% to 30% and its prognosis is mainly related to trauma severity.…”