A 'volume-targeted' approach to the management of TBI developed by a Swedish group (not ABBA), based on physiological volume regulation of the intracranial compartments. The Lund concept contradicts the prevailing strategem of titrating CPP to match ICP in TBI
Temperature and TBI. Induced hypothermia has been used for years to reduced cerebral metabolic rate; manipulation of temperature has been shown to effect certain types of brain injury (therapeutic hypothermia in out-of-hospital cardiac arrest).
polyuria following TBI is common; multiple causes, some of which imply a poor prognosis. Goal is to identify and treat the cause and any complications
Brain impact apneoa is an under-appreciated cause of morbidity and mortality in traumatic brain injury (TBI)
Limitations of CT head scan in Traumatic Brain Injury (TBI)
Cerebral Perfusion Pressure (CPP) in Traumatic brain injury (TBI). Cerebral Perfusion Pressure (CPP) = MAP – ICP or CVP (whichever is highest)
External Ventricular Drain (EVD): ICP monitor than allows CSF drainage; measurement and treatment of raised ICP
Base of Skull Fracture: fracture involving the floor of the cranial vault
Increased Intracranial Pressure in TBI; normal ICP 7-15mmHg sustained increases > 20mmHg is associated with ischaemic brain injury
Extradural ICP monitor: ICP monitoring; catheter inserted though a burr hole but does not penetrate the dura
Codman ICP Monitor: intracranial pressure monitor (aka 'BOLT')
The Monro-Kellie doctrine or hypothesis states that the sum of volumes of brain, cerebrospinal fluid (CSF) and intracerebral blood is constant. An increase in one should cause a reciprocal decrease in either one or both of the remaining two.