RT Book, Section
A1 Moulton, Richard J.
A1 Pitts, Lawrence H.
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Wood, Lawrence D.H.
SR Print(0)
ID 2297849
T1 Chapter 93. Head Injury and Intracranial Hypertension
T2 Principles of Critical Care, 3e
YR 2005
FD 2005
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071416405
LK accessanesthesiology.mhmedical.com/content.aspx?aid=2297849
RD 2022/08/15
AB Secondary  brain  injury  from  hypoxia  and  ischemia  should  be  prevented  by  appropriate  airway  ventilatory  and  fluid  management  in  all  comatose  patients.In  appropriately  selected  patients  aggressive  monitoring  and  treatment  of  intracranial  pressure  is  warranted.Early  identification  and  evacuation  of  operable  intracranial  hematomas  can  be  life-saving.Change  in  the  level  of  consciousness  is  one  of  the  hallmarks  of  brain  injury.  Its  recognition  through  careful  history,  physical  examination,  and  close  monitoring  is  therefore  essential.Prophylaxis  and  aggressive  treatment  of  seizures  following  head  injury  must  be  instituted.Maintenance  of  normal  fluid  and  electrolyte  balance  and  early  provision  of  enteral  nutrition  is  necessary.Risk  of  central  nervous  system  infection  is  reduced  by  surgical  débridement  and  restoration  of  dural  integrity  in  cases  of  open  cranial  injury.Systemic  sepsis  often  complicates  recovery  and  should  be  diagnosed  and  treated  aggressively.