TY  - CHAP
M1  - Book, Section
TI  - Traumatic Brain and Spinal Cord Injury
A1  - Dhawan, Vikram
A1  - Ullman, Jamie S.
A2  - Oropello, John M.
A2  - Pastores, Stephen M.
A2  - Kvetan, Vladimir
PY  - 1
T2  - Critical Care
AB  - KEY  POINTSTraumatic  brain  injury  is  primary  and  secondary.  Primary  injury  is  due  to  the  direct  impact  of  the  trauma,  while  secondary  is  due  to  hypoxia  leading  to  a  cascade  of  events  set  off  by  ischemia/reperfusion.  The  focus  of  management  is  prevention  and  treatment  of  secondary  injury.Severity  of  brain  injury  is  assessed  both  clinically  and  radiologically.  A  Glasgow  Coma  Scale  (normal  range  3-15)  of  13  to  15  is  considered  mild  brain  injury,  9  to  12  moderate,  and  3  to  8  severe  brain  injury.  The  Marshall  score  using  head  computed  tomography  (CT)  is  also  used  to  predict  severity.The  CT  scan  is  the  fastest  and  most  widely  used  initial  imaging  modality  available  for  skull  and  brain  parenchymal  lesions.  CT  angiography  and  perfusion  studies  further  help  to  characterize  vascular/perfusion  deficits.Preventing  and  treating  hypoxia  and  hypotension  to  prevent  hypoxia  and  adequate  perfusion  is  of  utmost  importance.Patients  with  risk  factors  for  spinal  cord  injury  should  be  handled  with  care  in  the  field  and  their  spine  stabilized  with  rigid  cervical  collars  on  a  board  with  straps.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1136416510
ER  -