"The purpose is to describe the integration of management for neurological injuries into the care of patients with trauma to multiple organ systems. Senior trainees with an interest in trauma or providers in a multidisciplinary trauma practice are an appropriate audience. ... a useful guide for neurosurgeons and those in other disciplines addressing injury. Neurosurgeons will better understand what to expect from other trauma team members, while the trauma team will have data describing optimal protection of the brain." (David J. Dries, Doody's Book Reviews, March, 2017)
Neurotrauma Management for the Severely Injured Polytrauma Patient
edited by James M. Ecklund and Leon E. Moores.
1 The Difficult Conversation
Leon E. Moores
2 Communication Between Teams and Multidisciplinary Rounds and Single Primary POC For Family Communication – Lessons Learned and Who’s In Charge?
A.B. Weisbrod, R. R. Armola, RN, J.R. Dunne
3 Mass Casualty Events and Your Hospital
Erich Gerhardt, Gary Vercruysse, Peter Rhee
4 Rural and Austere Environments
Jeffrey M. Lobosky
5 Prehospital Care and EMS Considerations in the Polytrauma Patient with CNS Injuries
Dan Avstreih, Scott Weir
6 AIS vs. ISS vs. GCS – What’s Going On Here?
Mayur Jayarao, Shelly D. Timmons
7 Trauma Resuscitation and Fluid Considerations in the Polytrauma Patient with CNS Injury
George P. Liao, John B. Holcomb
8 Initial Imaging Considerations, Repeat Imaging Frequency
Krzysztof M. Bochenek
9 Evidence Based Review of the Use of Steroids in Neurotrauma
Yiping Li, Kimberly Hamilton, Joshua Medow
10 Interventional Radiology in the Civilian Neurotrauma Setting
Richard M. Young, Jeffrey C. Mai
11 Vertebral artery injuries in penetrating neck and cervical spine trauma
Ralph Rahme, John F. Hamilton
12 Clearing the Cervical Spine in Blunt Trauma
Margaret M Griffen
13 Initial evaluation and management
Nilesh Vyas, Haralamos Gatos
14 Transport of the Neurotrauma Patient
Benjamin R. Huebner, Gina R. Dorlac, Warren C. Dorlac
15 Multiple Surgical Teams in the O. R. at Once – Priority of Effort
and Who Takes The Lead?
Neal D. Mehan, Matthew A. Bank, Jamie S. Ullman, Raj K. Narayan
16 Laparotomy for refractory ICP
Craig Shriver, Amy Vertrees
17 Associated Musculoskeletal Injuries
James R. Ficke, Brian J. Neuman
18 Neuro Anesthetic Considerations
John Dunford
19 Decompressive Craniectomy for Severe TBI
Charles A. Miller, Randy Bell
20 Hemodynamic Considerations in the Polytrauma Patient with
Traumatic Brain Injury (TBI)
Jing Wang, Laith Altaweel
21 Coagulopathy in Traumatic Brain Injury
John Dunford
22 Venous Thromboembolism Prophylaxis
Herb A. Phelan
23 Mechanical Ventilation in Traumatic Brain Injury
Christopher S. King, Laith Altaweel
24 Nutrition, Antibiotics, and Posttraumatic Seizure Prophylaxis
Erik J. Teicher and Christopher P. Michetti
25 Therapeutic Hypothermia for Traumatic Brain Injury and Spinal Cord Injury
Shamir Haji, Geoffrey S. F. Ling
26 Rehabilitation in the setting of Neuro-Trauma
Daniel Rhoades, Christian Bergman, Paul F. Pasquina
27 Craniofacial Reconstruction in the Polytrauma Patient
Raymond Harshbarger, Anand Kumar
28 Functional Restoration for Neurological Trauma: Current Therapies
and Future Directions
James Leiphart
29 Pediatric Neurotrauma
Ann-Christine Duhaime
30 Care of Patients with Burns and Traumatic Brain Injury
Leopoldo C. Cancio, Basil A. Pruitt Jr.
James M. Ecklund, M.D., F.A.C.S. serves as Chairman of the Inova Neuroscience Institute. Prior to joining Inova Medical Group, he served as Professor and Chairman of the Neurosurgery Program of the National Capital Consortium, which includes Walter Reed Army Medical Center, National Naval Medical Center and the Uniformed Services University. He is a retired colonel in the U.S Army and was deployed as a Neurosurgeon to both Afghanistan and Iraq. His program received the vast majority of American neurotrauma casualties.
Dr. Ecklund’s primary clinical and research interests include complex spine, cerebrovascular disease and neurotrauma with an emphasis on blast and penetrating injury. He directs a neurotrauma laboratory at the Uniformed Services University, has over 100 publications and abstracts, and has lectured throughout the world. He also has served on multiple oversight and advisory boards for the Veterans Administration, Department of Defense, National Institutes of Health, NATO, Neurotrauma Foundation, and Brain Trauma Foundation.
Leon E. Moores, MD, MS, FACS is the CEO of Pediatric Specialists of Virginia and the Associate Chair for Pediatric Programs at the Inova Neuroscience Institute. He retired as a Colonel from the US Army where he led as an Infantry Platoon Leader, Chief of Neurosurgery at Walter Reed, Chairman of the Department of Surgery at Walter Reed, Deputy Commander of the National Naval Medical Center, and Commander of the Fort Meade Medical System. Dr Moores also served two tours of duty in Afghanistan and Iraq.
Dr Moores’ clinical and research interests center on brain and spinal tumors in children, CNS infections in combat soldiers, and complex craniofacial reconstruction in severe head and facial trauma. He is a Professor of Surgery and Pediatrics at the Uniformed Services University, and a Professor of Neurosurgery at Virginia Commonwealth University.
This text addresses many of the questions which occur when medical professionals of various disciplines interact and have different plans and interventions, each with its own valid scientific and/or experience-based rationale: Questions involving tourniquet placement, ideal fluids and volumes for resuscitation, VTE prophylaxis and many other management considerations. Straightforward decisions in the patient with a single diagnosis often conflict when applied to the neurologically injured polytrauma patients.
Neurotrauma Management for the Severely Injured Polytrauma Patient answers as many of these questions as possible based on the current literature, vast experience with severe neurotrauma in the current conflicts in Afghanistan and Iraq, and the experience of trauma experts across the globe as well as proposes areas for future study where answers are currently less clear.