emDocs - February 6, 2017 - Author: Long B - Edited by: Koyfman A
"Key points
- Neurotrauma is common, as it is the leading cause of death in North America in those between ages 1 year to 45 years. Primary and secondary injuries result in severe morbidity and mortality.
- Neurotrauma includes head contusion, epidural hematoma, subdural hematoma, subarachnoid hemorrhage, diffuse axonal injury, skull fracture, and traumatic spinal cord injury.
- Cerebral perfusion pressure requires adequate cerebral blood flow.
- Evaluation and management in the emergency department entails initial stabilization and resuscitation while assessing neurologic status.
- Targeting mean arterial pressure, oxygen levels, and neurologic status are key components. ICP management should follow a tiered approach.
- Intubation of the patient with neurotrauma should be completed with several considerations.
- Hyperosmolar treatments include HTS and mannitol."