Guidelines for the Management of Severe Head Injury, 2nd Edition&lt;br/&gt;Guidelines from the Guidelines Committee on the Management of Severe Head Injury, the Japan Society of Neurotraumatology

Shigemori, Minoru; Abe, Toshiaki; Aruga, Tohru; Ogawa, Tomoya; Okudera, Hiroshi; Ono, Junichi; Onuma, Takehide; Katayama, Yoichi; Kawai, Nobuyuki; Kawamata, Tatsuro; Kohmura, Eiji; Sakaki, Toshisuke; Sakamoto, Tetsuya; Sasaki, Tatsuya; Sato, Akira; Shiogai, Toshiyuki; Shima, Katsuji; Sugiura, Kazuo; Takasato, Yoshio; Tokutomi, Takashi; Tomita, Hiroki; Toyoda, Izumi; Nagao, Seigo; Nakamura, Hiroshi; Park, Young Soo; Matsumae, Mitsunori; Miki, Takeyoshi; Miyake, Yasushi; Murai, Hisayuki; Murakami, Shigeyuki; Yamaura, Akira; Yamaki, Takashi; Yamada, Keiko; Yoshimine, Toshiki

doi:10.2176/nmc.52.1

Cited by 73 publications

(29 citation statements)

References 175 publications

(1 reference statement)

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“…Surgery was indicated on the basis of the Japanese Guidelines for the Management of Severe Head Injury [13]. Patients underwent either craniotomy or decompressive craniectomy for hematoma removal, and decision of which surgery to perform was made intraoperatively by an attending neurosurgeon on-call.…”

Section: Methodsmentioning

confidence: 99%

Hemispheric differences in the surgical outcomes of patients with traumatic acute subdural hematoma

Inamasu

Hasegawa

Hayashi

et al. 2014

J Negat Results BioMed

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BackgroundOur assumption that prognosis of patients with traumatic acute subdural hematoma (ASDH) does not differ significantly according to the hemispheric laterality has never been verified.MethodsA review of the charts/radiographic images of 61 adult traumatic ASDH patients (33 left/28 right) was conducted. Intergroup comparison was made on the demographics, autonomic/laboratory data, and outcomes (90-day mortality rate). Based on the presence of concomitant brain contusion, patients were further quadrichotomized as: left ASDH with contusion (n = 14), right ASDH with contusion (n = 16), left ASDH without contusion (n = 19), and right ASDH without contusion (n = 12). Comparisons were made on demographic and outcome variables between the left ASDH with contusion and right ASDH with contusion, and between the left ASDH without contusion and right ASDH without contusion. Multivariate regression analysis was conducted to identify clinical variables correlated with fatality.ResultsThere were no significant differences in the demographic, autonomic, and laboratory data between the left and right ASDH patients. However, 90-day mortality rate was significantly higher in the left ASDH patients when concomitant contusion was present (79% vs. 25%, p = 0.009). However, there were no significant hemispheric differences in the mortality rate among those without contusion (32% vs. 33%, p = 0.77). Multivariate regression analysis showed that left ASDH was correlated with fatality among those with contusion (OR: 6.620; 95% CI: 1.219-46.249).ConclusionsThis study is probably the first to report that the left ASDH patients fared substantially worse than the right-sided counterparts. Future trials on traumatic ASDHs may benefit from considering hemispheric differences in the outcomes.

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Section: Methodsmentioning

confidence: 99%

Hemispheric differences in the surgical outcomes of patients with traumatic acute subdural hematoma

Inamasu

Hasegawa

Hayashi

et al. 2014

J Negat Results BioMed

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“…Furthermore, systemic injury and/or brain parenchymal injury should be simultaneously evaluated and managed in accordance with treatment priority. 6) Intervention in TCVI is challenging and the outcome is often time-dependent. Our recent experience with TCVI is presented in order to share these rare but life-threatening entities of TBI and to hopefully prevent serious pitfalls.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Traumatic Cerebrovascular Injury: Pitfalls in the Management of Neurotrauma

Kobata

2017

Neurol. Med. Chir.(Tokyo)

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Traumatic cerebrovascular injury (TCVI) is an uncommon clinical entity in traumatic brain injury (TBI), yet it may cause devastating brain injury with high morbidity and mortality. Early recognition and prioritized strategic treatment are of paramount importance. A total of 1966 TBI patients admitted between 1999 and 2015 in our tertiary critical care center were reviewed. Screening of TCVI was based on the Guidelines for the Management of Severe Head Injury in Japan. TCVI was confirmed in 33 (1.7%) patients; 29 blunt and 4 penetrating injuries. The primary location of the injury included 16 cervical, 6 craniofacial, and 11 intracranial lesions. On arrival, 15 patients presented with hemorrhage, 5 of these arrived in shock status with massive hemorrhage. Ten presented with ischemic symptoms. Sixteen patients underwent surgical or endovascular intervention, 13 of whom required immediate treatment upon arrival. Surgical procedures included clipping or trapping for traumatic aneurysms, superficial temporal artery - middle cerebral artery bypass, carotid endarterectomy, and direct suture of the injured vessels. Endovascular intervention was undertaken in 7 patients; embolization with Gelfoam (Pharmacia and Upjohn Company, Kalamazoo, MI, USA) or coil for 6 hemorrhagic lesions and stent placement for 1 lesion causing ischemia. Patients’ outcome assessed by the Glasgow Outcome Scale at 3 months were good recovery in 8, moderate disability in 3, severe disability in 9, persistent vegetative state in 1, and death in 12, respectively. In order to rescue potentially salvageable TCVI patients, neurosurgeons in charge should be aware of TCVI and master basic skills of cerebrovascular surgical and endovascular procedures to utilize in an emergency setting.

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“…In intensive care clinical practice, continuous monitoring of core temperature in patients with brain injury is highly recommended [1]. It has been shown that, in cases of trauma, the brain is extremely sensitive and vulnerable to small temperature variations.…”

Section: Introductionmentioning

confidence: 99%

Brain Temperature: Physiology and Pathophysiology after Brain Injury

Mrozek

Vardon

Geeraerts

2012

Anesthesiology Research and Practice

138

128

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The regulation of brain temperature is largely dependent on the metabolic activity of brain tissue and remains complex. In intensive care clinical practice, the continuous monitoring of core temperature in patients with brain injury is currently highly recommended. After major brain injury, brain temperature is often higher than and can vary independently of systemic temperature. It has been shown that in cases of brain injury, the brain is extremely sensitive and vulnerable to small variations in temperature. The prevention of fever has been proposed as a therapeutic tool to limit neuronal injury. However, temperature control after traumatic brain injury, subarachnoid hemorrhage, or stroke can be challenging. Furthermore, fever may also have beneficial effects, especially in cases involving infections. While therapeutic hypothermia has shown beneficial effects in animal models, its use is still debated in clinical practice. This paper aims to describe the physiology and pathophysiology of changes in brain temperature after brain injury and to study the effects of controlling brain temperature after such injury.

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Guidelines for the Management of Severe Head Injury, 2nd Edition<br/>Guidelines from the Guidelines Committee on the Management of Severe Head Injury, the Japan Society of Neurotraumatology

Cited by 73 publications

References 175 publications

Hemispheric differences in the surgical outcomes of patients with traumatic acute subdural hematoma

Hemispheric differences in the surgical outcomes of patients with traumatic acute subdural hematoma

Diagnosis and Treatment of Traumatic Cerebrovascular Injury: Pitfalls in the Management of Neurotrauma

Brain Temperature: Physiology and Pathophysiology after Brain Injury

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