Guidelines for the surgical management of traumatic brain injury. Export

@article{citeulike:2874121, abstract = {INDICATIONS: Patients with parenchymal mass lesions and signs of progressive neurological deterioration referable to the lesion, medically refractory intracranial hypertension, or signs of mass effect on computed tomographic (CT) scan should be treated operatively. Patients with Glasgow Coma Scale (GCS) scores of 6 to 8 with frontal or temporal contusions greater than 20 cm3 in volume with midline shift of at least 5 mm and/or cisternal compression on CT scan, and patients with any lesion greater than 50 cm3 in volume should be treated operatively. Patients with parenchymal mass lesions who do not show evidence for neurological compromise, have controlled intracranial pressure (ICP), and no significant signs of mass effect on CT scan may be managed nonoperatively with intensive monitoring and serial imaging. TIMING AND METHODS: Craniotomy with evacuation of mass lesion is recommended for those patients with focal lesions and the surgical indications listed above, under Indications. Bifrontal decompressive craniectomy within 48 hours of injury is a treatment option for patients with diffuse, medically refractory posttraumatic cerebral edema and resultant intracranial hypertension.Decompressive procedures, including subtemporal decompression, temporal lobectomy, and hemispheric decompressive craniectomy, are treatment options for patients with refractory intracranial hypertension and diffuse parenchymal injury with clinical and radiographic evidence for impending transtentorial herniation.}, address = {Department of Neurological Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA.}, author = {Foundation, Brain T. and Bullock, M. R. and Chesnut, R. and Ghajar, J. and Gordon, D. and Hartl, R. and Newell, D. W. and Servadei, F. and Walters, B. C. and Wilberger, J.}, citeulike-article-id = {2874121}, citeulike-linkout-0 = {http://dx.doi.org/10.1227/01.NEU.0000210365.36914.E3}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/16540746}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=16540746}, doi = {10.1227/01.NEU.0000210365.36914.E3}, issn = {1524-4040}, journal = {Neurosurgery}, keywords = {14, 18, 8, guidelines, surgery, tbi}, month = {March}, number = {3 Suppl}, posted-at = {2008-06-08 23:24:19}, priority = {2}, title = {Guidelines for the surgical management of traumatic brain injury.}, url = {http://dx.doi.org/10.1227/01.NEU.0000210365.36914.E3}, volume = {58}, year = {2006} }

TY - JOUR ID - citeulike:2874121 L3 - citeulike-article-id:2874121 N2 - INDICATIONS: Patients with parenchymal mass lesions and signs of progressive neurological deterioration referable to the lesion, medically refractory intracranial hypertension, or signs of mass effect on computed tomographic (CT) scan should be treated operatively. Patients with Glasgow Coma Scale (GCS) scores of 6 to 8 with frontal or temporal contusions greater than 20 cm3 in volume with midline shift of at least 5 mm and/or cisternal compression on CT scan, and patients with any lesion greater than 50 cm3 in volume should be treated operatively. Patients with parenchymal mass lesions who do not show evidence for neurological compromise, have controlled intracranial pressure (ICP), and no significant signs of mass effect on CT scan may be managed nonoperatively with intensive monitoring and serial imaging. TIMING AND METHODS: Craniotomy with evacuation of mass lesion is recommended for those patients with focal lesions and the surgical indications listed above, under Indications. Bifrontal decompressive craniectomy within 48 hours of injury is a treatment option for patients with diffuse, medically refractory posttraumatic cerebral edema and resultant intracranial hypertension.Decompressive procedures, including subtemporal decompression, temporal lobectomy, and hemispheric decompressive craniectomy, are treatment options for patients with refractory intracranial hypertension and diffuse parenchymal injury with clinical and radiographic evidence for impending transtentorial herniation. IS - 3 Suppl JF - Neurosurgery SN - 1524-4040 AD - Department of Neurological Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. TI - Guidelines for the surgical management of traumatic brain injury. VL - 58 KW - 14 KW - 18 KW - 8 KW - guidelines KW - surgery KW - tbi AU - Foundation, Brain AU - Bullock, MR AU - Chesnut, R AU - Ghajar, J AU - Gordon, D AU - Hartl, R AU - Newell, DW AU - Servadei, F AU - Walters, BC AU - Wilberger, J PY - 2006/03// UR - http://dx.doi.org/10.1227/01.NEU.0000210365.36914.E3 ER -