How To Treat A Head Injury

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1 Contents Part I Epidemiology 1 Epidemiology Snorre Sollid and Tor Ingebrigtsen Part II Classi fi cation and Assessment 2 Classi fi cation of Head Injury Ramona Åstrand and Bertil Romner 3 Primary Clinical Assessment Jacob Bertram Springborg and Vagn Eskesen Part III Prehospital Management 4 Prehospital Management of Severe Traumatic Brain Injury (TBI) Snorre Sollid 5 What the Neurosurgeon Wants to Know: What, Who, When, and Where? Knut Wester 6 Transportation: Choice of Anaesthetic Drugs Niels Juul Part IV Admission, Diagnostics and Planning 7 Trauma Team Alert The Trauma Team Trauma Protocol (ABCDE) xiii

2 xiv Contents 10 Multi-trauma Triage Cervical Spine Injury Radiological Evaluation of Head Traumas Helle Wulf Eskildsen, Anna Tietze, and Vibeke Fink-Jensen 13 Radiological Evaluation of Cervical Spine Traumas Helle Wulf Eskildsen, Anna Tietze, and Vibeke Fink-Jensen 14 Blood Samples Rasmus Philip Nielsen 15 Prognosis of Severe Traumatic Brain Injury: To Treat or Not to Treat, That Is the Question Magnus Olivecrona 16 Potential Organ Donor: Organ Preservation Silvana Naredi Part V Acute Surgical Treatment 17 Basic Trauma Craniotomy Surgical Management of Traumatic Intracranial Haematomas Surgical Management of Penetrating Brain Injuries Decompressive Craniectomy Pål André Rønning 21 Skull Fractures Pål André Rønning 22 Vessel Injuries Pål André Rønning 23 Insertion of Intracranial Monitoring Devices Mikko Kauppinen 24 Maxillofacial Fractures Ann Hermansson

3 Contents xv Part VI Peroperative Anaesthesia 25 Choice of Anaesthesia Drugs and Medications Bent Lob Dahl 26 Blood Pressure, CO 2 and Oxygen Saturation Bent Lob Dahl 27 Intracranial Pressure Reduction Bent Lob Dahl Part VII Monitoring in Neurointensive Care 28 Secondary Clinical Assessment Jacob Bertram Springborg and Vagn Eskesen 29 A Neurological Wake-Up Test in the Neurointensive Care Unit: Pros and Cons Niklas Marklund 30 Intracranial Pressure (ICP) Peter Reinstrup 31 Brain Tissue Oxygen Monitoring Troels Halfeld Nielsen 32 Measurement of Brain Temperature Peter Reinstrup and Carl-Henrik Nordström 33 Monitoring Microdialysis Peter Reinstrup and Carl-Henrik Nordström 34 Jugular Bulb Measurements (SJVO 2 ) Bo-Michael Bellander and Peter Reinstrup 35 Cerebral Blood Flow (CBF) and Cerebral Metabolic Rate (CMR) Peter Reinstrup and Eric L. Bloom fi eld 36 Transcranial Doppler (TCD) Peter Reinstrup, Jan Frennström, and Bertil Romner 37 Near Infrared Spectroscopy (NIRS) or Cerebral Oximetry Peter Reinstrup and Bertil Romner 38 Clinical Neurophysiology: Evoked Potentials Birger Johnsen

4 xvi Contents 39 Clinical Neurophysiology: Continous EEG Monitoring Birger Johnsen 40 Radiological Follow-Up Leif Hovgaard Sørensen 41 Neuromarkers Ramona Åstrand, Johan Undén, Peter Reinstrup, and Bertil Romner 42 Cardiovascular Monitoring Karen-Lise Welling 43 Pulmonary Monitoring Jacob Koefoed-Nielsen 44 Renal Monitoring Jens Aage Kølsen-Petersen 45 Neuroendocrine Monitoring Marianne Klose and Ulla Feldt-Rasmussen 46 Microbiological Surveillance Mikala Wang and Jens Kjølseth Møller Part VIII Treatment in Neurointensive Care 47 Guidelines for Treatment of Patients with Severe Traumatic Brain Injury: Treatment Algorithms Niels Juul 48 The Lund Therapy for Severe Head Trauma Per-Olof Grände and Peter Reinstrup 49 Comparative Analysis of Various Guidelines for Treatment of Severe TBI Per-Olof Grände and Niels Juul 50 Pharmacological Neuroprotection in Severe Traumatic Brain Injury Niklas Marklund 51 Subacute Surgery in Neurointensive Care CSF Drainage Lars-Owe D. Koskinen

5 Contents xvii 53 Hyperventilation Niels Juul 54 Osmotherapy Jens Aage Kølsen-Petersen 55 Barbiturates for ICP Management Mads Rasmussen 56 Fluid Haemodynamics in Patients with Severe TBI Per-Olof Grände and Niels Juul 57 Sedation: Including Pain Treatment and Withdrawal Symptoms Silvana Naredi 58 Nutrition Anne Berit Guttormsen, Bram de Hoog, and Jennie Hernæs 59 Management of External Drain-Related CNS Infection Mikala Wang and Jens Kjølseth Møller 60 Management of Other Infections Steinar Skrede 61 Body Temperature in TBI Patients Per-Olof Grände and Bertil Romner 62 Neuroendocrine Treatment Marianne Klose and Ulla Feldt-Rasmussen 63 Mechanical Ventilation in NICU Jacob Koefoed-Nielsen 64 Seizures Elisabeth Ronne-Engström 65 Autonomic Dysfunction Prophylaxis Against Venous Thromboembolism in Patients with Traumatic Brain Injury Morten Zebitz Steiness 67 Brain Injury and the Haemostatic System Martin Engström 68 Steroids Jens Jakob Riis

6 xviii Contents Part IX Early Rehabilitation 69 Neurorehabilitation in Neurointensive Care Carsten Kock-Jensen and Leanne Enggaard Langhorn Part X Outcome After Severe TBI 70 Outcome After Severe Traumatic Brain Injury (TBI) Atle Ulvik and Reidar Kvåle 71 Subacute MR Imaging: Diffuse Axonal Injury, Brain Stem Lesions and Prognostic Factors Toril Skandsen and Anne Vik Part XI Research in the Neurointensive Care Unit 72 The Neurointensive Care Unit as a Platform for Advanced Clinical Research Per Enblad, Tim Howells, and Lars Hillered Index

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