The Use Of Increased Intracranial Pressure As A Result Of Severe Traumatic Brain Injury

Trauma patients often present paramedics with difficult situations to handle. These patients most likely have multiple injuries that the paramedic must treat including internal and external injuries. The main concern in treating trauma patients is controlling the pain that the patient may be experiencing while not compromising the patients hemodynamic and respiratory state. The most common drugs used in pain management in the pre-hospital setting often cause undesirable side effects, such as respiratory depression, hypotension, apnea, and bradycardia. All of these side effects combined with a trauma patient who is already compromised can lead to a much bigger issue. What if there was a drug that could treat the pain, calm the patient, and not cause the nasty side effects of traditional pain management? Ketamine provides us the answer to this question.

A Glasgow Coma Score of 8 or less also is an indication that the patient will need to be intubated soon. Once the tube is placed the ventilation may be useful in controlling the intracranial pressure as an intervention. Hyperventilation is a method used to reduce the carbon dioxide concentration in the vessels causing vasoconstriction which lessens the amount of blood circulating in the brain resulting in a decreased ICP (Zink and McQuillan, 2005). According to Zink and McQuillan, this intervention should only be utilized 24 hours after the initial injury because cerebral blood flow is often reduced at this point and constricting the vessels more may cause ischemia to occur. While using this technique it is important to monitor oxygenation to the brain tissue to assure no irreparable damage is

Traumatic Brain Injury isn’t a true leading cause of death but also represents a financial and personal burden, on the individual and the family. The injury affects all 3 parts within the intracranial space, also includes brain bulk, Cerebrospinal Fluid (CSF), and brain blood volume. Brain bulk increases after water influx to brain tissue or inflammatory response. CSF dynamics can be changed because of communicating hydrocephalus. Brain blood volume within the arterial and venous systems may cause a secondary injury. Also, it says, Intracranial pressure monitoring possibly will be effectively done by the means of an intraventricular catheter, enabling Cerebrospinal Fluid drainage and providing excellent Intercranial Pressure waveforms, facilitating ICP pulse-wave assessment of intracranial compliance.

When the brain experiences a traumatic injury, several cellular-level events happen quickly. First, there is an increase in supporting cell membrane permeability which leads to a rise in non-specific ion influx, followed by a rapid increase in glucose uptake. This increased glucose uptake results in increased in energy generation in an effort to correct the membrane permeability dysfunction.

At four years old, Casey was in a car accident. Her mother, Gloria, was driving while under the influence of alcohol and ran a red light, causing a side collision with another vehicle. Casey, who was in the passenger seat without a car seat, struck her face and head on the dashboard with great force.

Traumatic brain injury affects people from all walks of life. Form military personal to the elderly that get injured when they fall or even athletes in relation to the injuries they acquire. Traumatic brain injury progressively leads to complex pathophysiological events that may lead neurodegenerative complications. For those that have experienced traumatic brain damage are more susceptible for the development of diseases such as Alzheimer’s, dementia, epilepsy, posttraumatic stress disorder, and neuropsychiatric disorder. The progression of these diseases can occur in a span of a few weeks, months, or even decades after trauma, so it is important to look over the underlying pathophysiology that traumatic brain injury can cause after the injury

Examining the long-term effects of Traumatic Brain Injuries (TBI) are one of the many areas of brain behavior relationships neuropsychologists focus on. Consequently, studies review the effects obstacles have when attempting to remediate coping following TBI (Krpan, K. M., Anderson, N. D., & Stuss, D. T., 2013) while other studies have looked at the relationships between development in children who have suffered from TBI (Ganesalingam, K., Yeates, K. O., Sanson, A. and Anderson, V., 2007). In a highly specialized study, researchers discussed the sex differences in orbitofrontal connectivity in male and female veterans with TBI (McGlade, E., Rogowska, J. & Yurgelun-Todd, D., 2015). Nevertheless, while these studies are examining different ways TBI are influencing different behavioral changes in all ranges of people, they all focus on specific brain behavior relationships. The further purpose of these studies is to determine the best rehabilitation methods to achieve the highest possibility of cognitive functioning. Through the examination of how TBI effect certain areas of the brain, this will allow neuropsychologists to focus rehabilitation efforts specifically on the areas with the most concentrated brain damage.

Traumatic brain injuries are one of the leading causes for damage in the brain and lesions (TBI) (Wheeler, Nickerson, Long & Silver, 2014). Two types of injuries that occur following brain damage are open and closed head injuries. Open head injuries are often fatal and occur in such cases as when objects such as bullets penetrate the head of the victim. Closed head injuries result from blows to the head in situations such as car accidents or sports injuries. TBIs normally evolve in two forms: primary damage which occurs upon the impact of the cause and secondary brain damage which is progressive over the time of the trauma. Research has indicated that TBI greatly affects both cognitive and executive functions resulting in memory loss and reasoning problems. They encounter difficulties in solving problems, making proper judgments and decision-making. Underlying causes from TBI are what result in several writing deficits. Expressive writing is one of the major writing disorders that are caused by TBIs (Wheeler, Nickerson, Long & Silver, 2014). Research has shown that the general TBI population suffers from this and it is notable in school children because they engage in activities that are affected by this particular disorder. Those who suffer from TBI are subjected to a multitude of writing issues in both aspects of expressive writing: higher order skills and lower order skills. Higher order skills affect sequencing, planning, and organization of writing while

Extensive research offers hope for the growing numbers of people suffering from traumatic brain injuries that often leave victims unable to return to their previous lifestyle and sometimes require long-term care. Traumatic brain injuries are quite common from car accidents, a blow to the head, sports accidents, and in military veterans. These injuries have a long term effect that changes lives of many individuals. Some brain injuries, even have the power to change the way one speaks and complete simple everyday tasks which restrict one to be independent.

A TBI occurs when one has sustained tremendous and sudden amount of brain damage (American Speech- Language - Hearing Association, 2015). Brain injuries are classified as open or closed injuries depending on if the skull has been penetrated (American Speech- Language - Hearing Association, 2015). The leading causes of TBI’s include: falls, motor vehicle and pedestrian- related accidents, collision-

In the military setting, wide decompression carries the benefit of reducing malignant brain edema and elevations in ICP in the first several hours after the TBI (intro 15,16). However, the patients with large cranial defects and complex brain injuries remain as a challenge, and the outcome at severe primary or secondary blast injuries of children varies from adult one. Therefore, conclusive evidence of whether it has a beneficial or adverse effect on outcome is lacking (Intro4, trat 9). Children have more shearing and diffuse damage than adults. Even the definition of normal ICP and CPP varies with age (intro19). The differences in bio-structure of children’s brain from adult including more edema, hypotension, cardiac output, and less antioxidative capacity and basement membrane glycoproteins. Better outcome in children would be explained by several factors such as low level of chondrotin sulfate proteoglycan glycoproteins, which is responsible for rigidity and support of parenchyme (intro18,

Traumatic Brain Injuries are serious issues in the United States for health care providers (Centers for Disease Control and Prevention, 2015). A TBI occurs

Traumatic brain injury may be the most prevalent and least understood neurological disorder in both civilian and military lifestyles. Every year there are thousands of traumatic brain injuries; in 2015, there were about 18,000 documented cases in the Military alone, Since 2000 there have been more than 339,000 reported cases.(DoD Worldwide Numbers for TBI. 2012) A traumatic brain injury or TBI is any damage to the brain from an applied force the forces involved can be from direct contact as in a blunt or penetrating head injury; or from rotational energy that produces shear stress between the brain and the skull. (traumatic brain injury, 2016). Military service members are at an increasingly higher risk of Contracting a TBI because of their

Traumatic brain injury (TBI) is defined as an external force caused changes in brain function or other evidence of brain pathology (Menon, Schwab, Wright, & Maas, 2010, p. 1638). Assessed with Glasgow Coma Scale (GCS) score, TBI is categorised into four injuries, namely minor (GCS=15), mild (GCS≥13), moderate (GCS 9-12), and severe (GCS ≤8) (Parsons & Hammeke, 2014, p. 211). Chronologically, TBI is divided into primary and secondary injuries (Gean & Fischbein 2010, p. 527). Primary injury occurs at the moment of injury with immediate brain tissue shearing and compression; whereas secondary injuries occur as a consequential physiologic response to primary injury that happens in the next hours and days. Increased intracranial pressure (ICP),

The human brain is a scientific marvel: billions of microscopic cells bind together just so, and form a structure that regulates and processes every aspect of life, from keeping blood at just the right pH, to processing the gentle caress of a loved one. Other body parts are expendable or replaceable: kidneys can be transplanted, livers can be transplanted, even penises can be transplanted. The human brain, however, cannot. It is so essential that if it goes even a few minutes without nutrients, death can result. A nourished brain, however, is able to control muscle movement, judgment, reasoning, memory, process visual information, and comprehend language. This is why damage to the brain can be devastating, no matter how small or insignificant the injury may seem. There is no surefire way to prevent damage to the brain from ever occurring, but it is possible to manage the symptoms that develop in the aftermath.