Severe head injury managed without intracranial pressure monitoring

Restricted access

✓ A prospective series of 100 consecutive severe head injuries is presented. There were 34 deaths. Intracranial pressure (ICP) was not monitored in this series, and it is suggested that the outcome compares favorably with series in which ICP monitoring was performed. Early evacuation of life-threatening intracranial hematoma and airway control remain essentials of treatment of severe head injury.

Article Information

Address reprint requests to: Gordon G. Stuart, F.R.A.C.S., Kenneth G. Jamieson Neurosurgical Unit, Royal Brisbane Hospital, Queensland, Australia.

© AANS, except where prohibited by US copyright law.

Headings

References

  • 1.

    Becker DPMiller JDWard JDet al: The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg 47:4915021977Becker DP Miller JD Ward JD et al: The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg 47:491–502 1977

  • 2.

    Bricolo ATurazzi SAlexandre Aet al: Decerebrate rigidity in acute head injury. J Neurosurg 47:6806981977Bricolo A Turazzi S Alexandre A et al: Decerebrate rigidity in acute head injury. J Neurosurg 47:680–698 1977

  • 3.

    Bruce DASchut LBruno LAet al: Outcome following severe head injuries in children. J Neurosurg 48:6796881978Bruce DA Schut L Bruno LA et al: Outcome following severe head injuries in children. J Neurosurg 48:679–688 1978

  • 4.

    Carlsson CAvon Essen CLöfgren J: Factors affecting the clinical course of patients with severe head injuries. Part 1: Influence of biological factors. Part 2: Significance of posttraumatic coma. J Neurosurg 29:2422511968Carlsson CA von Essen C Löfgren J: Factors affecting the clinical course of patients with severe head injuries. Part 1: Influence of biological factors. Part 2: Significance of posttraumatic coma. J Neurosurg 29:242–251 1968

  • 5.

    Cooper PRMoody SClark WKet al: Dexamethasone and severe head injury. A prospective double-blind study. J Neurosurg 51:3073161979Cooper PR Moody S Clark WK et al: Dexamethasone and severe head injury. A prospective double-blind study. J Neurosurg 51:307–316 1979

  • 6.

    Hooper R: Observations on extradural haemorrhage. Br J Surg 47:71871959Hooper R: Observations on extradural haemorrhage. Br J Surg 47:71–87 1959

  • 7.

    Heiskanen DSipponen P: Prognosis of severe brain injury. Acta Neurol Scand 46:3433481970Heiskanen D Sipponen P: Prognosis of severe brain injury. Acta Neurol Scand 46:343–348 1970

  • 8.

    Jamieson KGYelland JDN: Extradural hematoma. Report of 167 cases. J Neurosurg 29:13231968Jamieson KG Yelland JDN: Extradural hematoma. Report of 167 cases. J Neurosurg 29:13–23 1968

  • 9.

    Jamieson KGYelland JDN: Surgically treated traumatic subdural hematomas. J Neurosurg 37:1371491972Jamieson KG Yelland JDN: Surgically treated traumatic subdural hematomas. J Neurosurg 37:137–149 1972

  • 10.

    Jennett BBond M: Assessment of outcome after severe brain damage. A practical scale. Lancet 1:4804841975Jennett B Bond M: Assessment of outcome after severe brain damage. A practical scale. Lancet 1:480–484 1975

  • 11.

    Jennett BTeasdale G: Aspects of coma after severe head injury. Lancet 1:8788811977Jennett B Teasdale G: Aspects of coma after severe head injury. Lancet 1:878–881 1977

  • 12.

    Jennett BTeasdale GBraakman Ret al: Prognosis of patients with severe head injury. Neurosurgery 4:2832891979Jennett B Teasdale G Braakman R et al: Prognosis of patients with severe head injury. Neurosurgery 4:283–289 1979

  • 13.

    Jennett BTeasdale GFry Jet al: Treatment for severe head injury. J Neurol Neurosurg Psychiatry 43:2892951980Jennett B Teasdale G Fry J et al: Treatment for severe head injury. J Neurol Neurosurg Psychiatry 43:289–295 1980

  • 14.

    Jennett BTeasdale GGalbraith Set al: Severe head injuries in three countries. J Neurol Neurosurg Psychiatry 40:2912981977Jennett B Teasdale G Galbraith S et al: Severe head injuries in three countries. J Neurol Neurosurg Psychiatry 40:291–298 1977

  • 15.

    Marshall LFSmith RWShapiro HM: The outcome with aggressive treatment in severe head injuries. Part I: The significance of intracranial pressure monitoring. J Neurosurg 50:20251979Marshall LF Smith RW Shapiro HM: The outcome with aggressive treatment in severe head injuries. Part I: The significance of intracranial pressure monitoring. J Neurosurg 50:20–25 1979

  • 16.

    Marshall LFSmith RWShapiro HM: The outcome with aggressive treatment in severe head injuries. Part II: Acute and chronic barbiturate administration in the management of head injury. J Neurosurg 50:26301979Marshall LF Smith RW Shapiro HM: The outcome with aggressive treatment in severe head injuries. Part II: Acute and chronic barbiturate administration in the management of head injury. J Neurosurg 50:26–30 1979

  • 17.

    Miller JDButterworth JFGudeman SKet al: Further experience in the management of severe head injury. J Neurosurg 54:2892991981Miller JD Butterworth JF Gudeman SK et al: Further experience in the management of severe head injury. J Neurosurg 54:289–299 1981

  • 18.

    Pazzaglia PFrank GFrank Fet al: Clinical course and prognosis of acute post-traumatic coma. J Neurol Neurosurg Psychiatry 38:1491541975Pazzaglia P Frank G Frank F et al: Clinical course and prognosis of acute post-traumatic coma. J Neurol Neurosurg Psychiatry 38:149–154 1975

  • 19.

    Rosner MJBecker DP: ICP monitoring: complications and associated factors. Clin Neurosurg 23:4945191976Rosner MJ Becker DP: ICP monitoring: complications and associated factors. Clin Neurosurg 23:494–519 1976

  • 20.

    Saul TGDucker TB: Effect of intracranial pressure monitoring and aggressive treatment on mortality in severe head injury. J Neurosurg 56:4985031982Saul TG Ducker TB: Effect of intracranial pressure monitoring and aggressive treatment on mortality in severe head injury. J Neurosurg 56:498–503 1982

  • 21.

    Seeling JMBecker DPMiller JDet al: Traumatic acute subdural hematoma. Major mortality reduction in comatose patients treated within four hours. N Engl J Med 304:151115181981Seeling JM Becker DP Miller JD et al: Traumatic acute subdural hematoma. Major mortality reduction in comatose patients treated within four hours. N Engl J Med 304:1511–1518 1981

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 35 35 6
Full Text Views 160 160 0
PDF Downloads 101 101 0
EPUB Downloads 0 0 0

PubMed

Google Scholar