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Chapter 17 - Surgical Issues in the Management of Head-Injured Patients

Published online by Cambridge University Press:  28 April 2020

By
Jane Halliday ,
Peter C. Whitfield  and
Puneet Plaha
Edited by
Peter C. Whitfield ,
Jessie Welbourne ,
Elfyn Thomas ,
Fiona Summers ,
Maggie Whyte  and
Peter J. Hutchinson
Peter C. Whitfield
Affiliation:
Derriford Hospital, Plymouth
Jessie Welbourne
Affiliation:
University Hospitals, Plymouth
Elfyn Thomas
Affiliation:
Derriford Hospital, Plymouth
Fiona Summers
Affiliation:
Aberdeen Royal Infirmary
Maggie Whyte
Affiliation:
Aberdeen Royal Infirmary
Peter J. Hutchinson
Affiliation:
Addenbrooke’s Hospital, Cambridge
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Summary

This chapter reviews the indications for surgical intervention and operative nuances that may facilitate neurosurgical procedures. We discuss the surgical management of patients with traumatic intracranial haematomas, depressed skull fractures, the placement of external ventricular drains and the application of decompressive craniectomy.

The overall goal of all surgical treatment is to prevent secondary injury by helping to maintain blood flow and oxygen to the brain and minimise swelling and pressure. Survival from traumatic head injury has improved significantly over the last 20 years, reflecting improved pre-hospital and neuro-intensive care management of head-injured patients, as well as the introduction of the NICE head injury guidelines in 2003, which has led to a greater number of trauma patients undergoing computed tomography (CT) of the head.

Type
Chapter
Information
Traumatic Brain Injury
A Multidisciplinary Approach
 , pp. 207 - 221
Publisher: Cambridge University Press
Print publication year: 2020

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