Comparison of Care System and Treatment Approaches for Patients with Traumatic Brain Injury in China versus Europe: A CENTER-TBI Survey Study

Management of traumatic brain injury in China versus Europe – Authors' reply

“…1 The data have been prospectively collected following the methods of the Collaborative European Neuro Trauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) registry, which paved a practical way for comparative analysis in the care of traumatic brain injury between China and Europe, as reported in August, 2020, by Feng and colleagues. 2 The proportion of patients with hypotension following traumatic brain injury in our study was 2•1% (279 of 13 138), 1 which is lower than that reported by Spaite and colleagues 3 and Stassen and colleagues. 4 We enrolled patients with traumatic brain injury of all severities, 7404 (56%) of whom had mild traumatic brain injury, whereas the studies by Spaite and colleagues and Stassen and colleagues enrolled patients with moderate and severe traumatic brain injury only.…”

Effect of primary decompressive craniectomy on outcomes in severe traumatic brain injury with mass lesions and the independent predictors for operation decision

“…Instead, in China, CT scans are done for patients with TBI in all hospitals with departments of neurosurgery [1]. Primary DC is most often performed for clinical and radiographic evidence of herniation, rather than for refractory ICP elevation [29].Moreover, we found that DC in TBI was performed in Chinese centers more often than that in European centers [2,15].…”

“…However, in China, most patients admitted to the intensive care unit (ICU) with severe TBI did not receive an intracranial pressure (ICP) monitoring device [2], re ect the role of clinical assessment and imaging in making treatment decisions ,or economic constraints in case of non-reimbursement [14]. In contrast, computed tomography (CT) scans are done for patients with TBI in all hospitals with departments of neurosurgery in China [13].Moreover, we found that decompressive craniectomy (DC) in refractory ICP was performed in Chinese centers more often than that in European centers [15]. This procedure is recommended (level II A evidence) in the Brain Trauma Foundation guidelines [16].…”

Brain-Derived Neurotrophic Factor and Nerve Growth Factor Therapeutics for Brain Injury: The Current Translational Challenges in Preclinical and Clinical Research

“…TBI occurs following a bump, blow, or jolt to the brain that causes brain edema and results in neuronal cell death. Treatment options for TBI are similarly lacking, with typical immediate interventions including hyperosmolar therapy to relieve intracranial pressure [ 37 , 38 ] and invasive decompressive surgery [ 39 ]. Although there are a variety of pharmacological interventions that can be used following TBI depending on the severity and details of the brain injury, many of these are used to manage TBI sequelae including seizure, clotting, depression, and anxiety as opposed to enhancing neuroprotection and neural repair mechanisms to address cell death.…”