Pathophysiology and Management of Intracranial Hypertension and Tissular Brain Hypoxia After Severe Traumatic Brain Injury: An Integrative Approach

Daniel Agustín Godoy, Santiago Lubillo, Alejandro Rabinstein

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

Monitoring intracranial pressure in comatose patients with severe traumatic brain injury (TBI) is considered necessary by most experts. Acute intracranial hypertension (IHT), when severe and sustained, is a life-threatening complication that demands emergency treatment. Yet, secondary anoxic-ischemic injury after brain trauma can occur in the absence of IHT. In such cases, adding other monitoring modalities can alert clinicians when the patient is in a state of energy failure. This article reviews the mechanisms, diagnosis, and treatment of IHT and brain hypoxia after TBI, emphasizing the need to develop a physiologically integrative approach to the management of these complex situations.

Original languageEnglish (US)
Pages (from-to)195-212
Number of pages18
JournalNeurosurgery Clinics of North America
Volume29
Issue number2
DOIs
StatePublished - Apr 1 2018

Keywords

  • Acute brain injury
  • Brain hypoxia
  • Cerebral oxygenation
  • Cerebral perfusion pressure
  • Intracranial hypertension
  • Intracranial pressure
  • Multimodal monitoring
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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