Management of patients with head injuries and multiple other trauma

Abstract

The management of patients with multiple trauma including head injuries is a complex task. The prime goal is to minimize secondary neuronal injury. Attention to establishment of an airway, assurance of adequate gas exchange, and circulatory resuscitation is mandatory to minimize any secondary neuronal injuries. Once these principles of resuscitation have been applied and the primary neuronal injury is treated, additional etiologies of secondary brain trauma, such as hypoglycemia and hypothermia, should be addressed. Continual monitoring of oxygenation and perfusion is mandatory optimizing the outcome of these patients.

Systemic inflammation exacerbates behavioral and histopathological consequences of isolated traumatic brain injury in rats

“…In a 1990 study of 328 patients, those patients with multiple injuries aside from TBI had significantly less favorable outcomes than TBI alone (Groswasser et al, 1990). In a separate study, patients with extra-cranial injuries in addition to head trauma had a mortality level almost twice of those with TBI alone (TBI 11.1%, polytrauma 21.8%) (Wilson and Tyburski, 2001). Thus, the pathophysiology of polytrauma as it relates to outcome after TBI is a topic of current clinical interest (Keel and Trentz, 2005).…”

Contributions of Interleukin-1 Receptor Signaling in Traumatic Brain Injury

“…Polytrauma is common in the context of TBI and leads to profound peripheral inflammatory responses that may exacerbate neuroinflammation. Clinically, patients with polytrauma exhibit increased mortality rates compared to TBI alone: 21.8-11.1%, respectively (Wilson and Tyburski, 2001;McDonald et al, 2016;Sun et al, 2018). Controlled cortical impact (CCI) in combination with tibial injury increases brain levels of IL-1β in mice receiving both injuries compared to those receiving only TBI (Yang et al, 2016).…”