Neurotrauma and Critical Care of the Brain Second Edition Ebook PDF
Neurotrauma and Critical Care of the Brain Second Edition Ebook PDF This chapter describes progressive changes in the medical and surgical approach to traumatic brain injury (TBI). First we illustrate the attempts to surgical treatment of blunt and penetrating head injuries caused by combats. During the First and Second World Wars, military medicine incorporated fundamental concepts, from early intervention to asepsis, that improved the discouraging results of delayed surgical treatment with intractable infections.
Then we summarize improvements in central nervous system exploration, from intracranial pressure measurement (and then monitoring) to a more complete understanding of intracranial pathophysiology, as developed in neurosurgery, neuroanesthesia, and with revolutionary imaging tools such as the CT (computed tomography) scan. The birth of intensive care, based on supported ventilation, accurate and systematic monitoring, and specialized personnel, is described. Concurrently, renewed interest in TBI led to large, multicenter observational studies. These became possible when standardized scales for severity and outcome measurement were broadly used worldwide. The predominant nihilistic attitude toward the most severe cases changed when data on aggressive and tailored medical treatment, combined with neurosurgery, were published. These studies demonstrated the improvements in the outcome of TBI patients and set the standard for modern TBI management.
This chapter describes how TBI care has evolved, with special focus on how critical care has become an integral part of TBI treatment.
Keywords: traumatic brain injury, critical care, neurosurgery, neuroradiology, history