Neurosurgery
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Venous thromboembolism (VTE) is a common complication of traumatic brain injury (TBI) with an estimated incidence of 25% when chemoprophylaxis is delayed. The timing of initiating prophylaxis is controversial given the concern for hemorrhage expansion. The objective of this study was to determine the safety of initiating VTE chemoprophylaxis in patients with TBI within 24 hours of presentation. ⋯ Early (<24 hours) initiation of VTE chemoprophylaxis in patients with traumatic intracranial hemorrhage appears to be safe. Further prospective studies are needed to validate this finding.
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It became increasingly necessary to rethink the value and clinical implication of traumatic brain injury (TBI) management guided by intracranial pressure (ICP) monitoring. ⋯ There were multiple differences between the ICP monitoring and no ICP monitoring groups regarding patient characteristics, injury severity, characteristics of CT scan, and hospital type. ICP monitoring in conjunction with ICP targeted therapies is significantly associated with lower mortality in some special TBI subgroups.