• Neurosurg. Clin. N. Am. · Apr 2018

    Review

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

    • Daniel Agustín Godoy, Santiago Lubillo, and Alejandro A Rabinstein.
    • Intensive Care Unit, San Juan Bautista Hospital, Catamarca, Argentina; Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina. Electronic address: dagodoytorres@yahoo.com.ar.
    • Neurosurg. Clin. N. Am. 2018 Apr 1; 29 (2): 195-212.

    AbstractMonitoring 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.Copyright © 2018 Elsevier Inc. All rights reserved.

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