Haemodynamics · Neurocritical Care · Neurotrauma · Pharmacology · Traumatic Brain Injury

Another Trial Suggesting Beta-blockers Are Beneficial in TBI: Time for an RCT!

We covered the subject of beta-blockade in traumatic brain injury last autumn in this article, where we summarised the increasing evidence that it seems to improve survival. A recently published trial (free full text) in the Journal of Trauma and Acute Care Surgery adds further credence to the role of beta-blockers in this patient group. This… Continue reading Another Trial Suggesting Beta-blockers Are Beneficial in TBI: Time for an RCT!

Neurocritical Care · Neuroprotection · Neurotrauma · Traumatic Brain Injury

Lancet Neurology – Special Issue Dedicated to TBI

I realise that this is old news by now, but I´ve somehow neglected to put out this excellent collection of articles on NeuroScand. The November issue of Lancet Neurology is dedicated in its entirety to traumatic brain injury and features a number of inspiring and thought-provoking editorials. Essential reading for the neurotrauma enthusiast.

Basic Sciences & Physiology · Haemodynamics · ICP/CPP management · Neurocritical Care · Neuromonitoring · Traumatic Brain Injury

Cerebral Autoregulation – What do we know?

We all recall the elegant curves that ostensibly show the neat relationship between mean  arterial blood pressure (or CPP) and cerebral blood flow. This relationship classically has its lower and upper limits, beyond which CBF will vary passively with the systemic pressure. Stay within these limits and all is good, the mantra goes. However, as… Continue reading Cerebral Autoregulation – What do we know?

Neurocritical Care · Neuroprotection · Thermoregulation · Traumatic Brain Injury

TTM – New Guidelines from NCS

Targeted temperature management (TTM) as a neuroptotective strategy is applied in a number of scenarios; post-ROSC in cardiac arrest, neonatal asphyxia, traumatic brain injury, to name some. The Neurocritical Care Society have taken it upon themselves to formulate an evidence-based guideline to  the implementation and practical management of TTM in a number of settings. Although… Continue reading TTM – New Guidelines from NCS

Neurocritical Care · Neuromonitoring · Traumatic Brain Injury

Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II: A Phase II Randomized Trial

Okonkwo et al, ten ICUs in the United States. Read their article in Critical Care Medicine, November 2017-issue. They found that management of severe traumatic brain injury informed by multimodal intracranial pressure and brain tissue monitoring reduced brain tissue hypoxia, with a trend toward lower mortality and more favorable outcomes, compared with treatment guided by… Continue reading Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II: A Phase II Randomized Trial

Cardiovascular Conditions · Haemodynamics · Pharmacology · Systemic Effects of CNS Pathology · Traumatic Brain Injury

Beta-blockers and TBI

This is a subject that has been on our backburner for a while and it’s now due for a discussion on neuroscand.com. The use of beta-blockers in traumatic brain injury is nothing new. The indications have been largely centered on targeting and preventing paroxysmal sympathetic hyperactivity (PSH) and associated post-TBI autonomic phenomena. Please see our… Continue reading Beta-blockers and TBI

Cardiovascular Conditions · Haemodynamics · Neurotrauma · Systemic Effects of CNS Pathology · Traumatic Brain Injury

Lancet: Paroxysmal Sympathetic Hyperactivity after TBI – An Underrecognized Clinical Entity

We have probably all struggled with these phenomena in our TBI patients in the neuro ICU: swinging blood pressures, episodic tachycardia and fever, occurring even several weeks after the initial traumatic event. In this article in the Lancet, Meyfroidt and colleagues offer us some insight into the clinical syndrome now known as paroxysmal sympathetic hyperreactivity.… Continue reading Lancet: Paroxysmal Sympathetic Hyperactivity after TBI – An Underrecognized Clinical Entity

Conferences · Neurotrauma · Prognostication · Traumatic Brain Injury

New Article in PLOS: Reevaluating CT Scoring Systems for TBI

In this article Swedish and Finnish colleagues (Thelin et al) look at current scoring systems for CT imaging in TBI patients. Most older systems in use today seem to be increasingly outdated and are limited in their diagnostic and prognostic accuracy. It is the latter the authors seem to focus on in this observational multicenter… Continue reading New Article in PLOS: Reevaluating CT Scoring Systems for TBI