Management of Patients With Traumatic Intracranial Injury in Hospitals Without Neurosurgical Service

Abstract

Despite the small sample size of this study, the presented data suggest that some patients with ICB can be safely and definitively managed in centers with no on-site neurosurgical service. The need for transfer may be based on telemedicine consultation or clinical -radiologic guidelines. Further larger scale studies are warranted.

Interhospital Transfer of Neurosurgical Patients to a High-Volume Tertiary Care Center

“…Teleradiology may also allow select patients to be treated at level 2 trauma centers and to avoid unnecessary transfer to a higher level of care. 25,26 Incorporating teleradiology and other digital technologies into the transfer process can increase the efficiency of transfer and patient care while ultimately improving patient outcomes.…”

Cumulative incidence and predictors of neurosurgical interventions following nonsevere traumatic brain injury with mildly abnormal head imaging findings

“…4Y6 Two recent studies examine the need for neurosurgical consultation in patients with mild TBI. 7,8 Although both of these studies suggest that physicians may be obtaining neurosurgical consultation more often than needed, the small numbers, variations in definition of head CT findings, and neurosurgical intervention as well as the GCS score threshold used limit the ability to draw any definitive conclusions from these data.…”

Should the Management of Isolated Traumatic Subarachnoid Hemorrhage Differ From Concussion in the Setting of Mild Traumatic Brain Injury?

“…Klein et al 18 further substantiate these observations in a study that examined transfer of TBI patients with a GCS score of 13 to 15 and a positive CT scan for ICH initially seen in hospitals with no onsite neurosurgical service. Transfer to a neurosurgical center was based on telemedicine neurosurgical consultation or clinical-radiologic guidelines.…”