Articles: trauma.
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Data from MRI can be used to generate detailed maps of central nervous system anatomy and functional activation. Here, we review new research that integrates advanced MRI acquisition and analysis to predict and track recovery following severe traumatic brain injury (TBI) or anoxic ischemic encephalopathy (AIE) following cardiac arrest. ⋯ MRI of the brain is feasible in critically ill patients following TBI or cardiac arrest, revealing patterns of structural damage and functional disconnection that can help predict outcome in the long term. Prospective studies are needed to validate these findings and to identify relationships between MRI-defined alterations and specific postinjury cognitive and behavioural phenotypes.
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Curr Opin Crit Care · Apr 2014
ReviewTranscranial Doppler after traumatic brain injury: is there a role?
To present the practical aspects of transcranial Doppler (TCD) and provide evidence supporting its use for the management of traumatic brain injury (TBI) patients. ⋯ The diagnostic value of TCD should be incorporated into other findings from multimodal brain monitoring and CT scan to optimize the bedside management of patients with TBI and help guide the choice of appropriate therapies.
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We review topics pertinent to the perioperative care of patients with neurological disorders. Our review addresses topics not only in the anesthesiology literature, but also in basic neurosciences, critical care medicine, neurology, neurosurgery, radiology, and internal medicine literature. ⋯ As our review is not able to include all manuscripts, we focus on recurring themes and unique and pivotal investigations. We address the broad topics of general neuroanesthesia, stroke, traumatic brain injury, anesthetic neurotoxicity, neuroprotection, pharmacology, physiology, and nervous system monitoring.
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In 1978 the Advanced Trauma Life Support guidelines were first implemented and are viewed by many as the gold standard of care in the emergency setting. It may not be immediately obvious where assessment and management of maxillofacial injuries fits within these trauma guidelines. This article aims to provide a concise, contemporary guide for the treatment of maxillofacial trauma in the emergency setting. ⋯ It is imperative that sight preserving assessment and interventions are not forgotten in the emergency management of maxillofacial trauma. We propose an algorithm for the management of maxillofacial trauma, and recommend the use of CT as a powerful adjunct to clinical examination in patients with maxillofacial trauma.
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Curr Opin Crit Care · Apr 2014
ReviewIsolated abdominal trauma: diagnosis and clinical management considerations.
The scope of the present study is to review the topics of initial assessment, diagnosis and clinical management of an isolated abdominal trauma. ⋯ Abdominal trauma is a complex injury; the multidisciplinary approach has made nonoperative management feasible and effective. When surgical intervention is needed, it should be performed in an orderly fashion, within the context of the overall management.