Brain Injury review

This article by Jiang and Yang from the department of neurosurgery at the Shanghai Jiaotong University takes a look at the effects of hypothermia  on traumatic brain injuries.
PURPOSE OF REVIEW: The aim of this article is to review the current status of protective effects of mild-to-moderate hypothermia on traumatic brain injury.

RECENT FINDINGS: More than 30 clinical studies have reported effects of therapeutic hypothermia on outcome of traumatic brain injury and cerebral ischemia. Only one clinical trial of short-term mild hypothermia did not show any effect in patients with severe traumatic brain injury. Long-term mild hypothermia may be useful for severe traumatic brain-injured patients.

SUMMARY: Mild-to-moderate hypothermia plays a significant role in cerebral protection after traumatic brain injury.

The full article can be found via pubmed using the id number 17327735

Recent research by f Servardei and colleagues has taken a look into corelation of intracranial hematomas and external decrompression. The abstract in full can be found using the pubmed identifier 17327737. The group hail from the autonomous university of Barcelona.

PURPOSE OF REVIEW: To identify the surgical indications in the treatment of posttraumatic intracranial hematomas and to evaluate the role of external decompression in severe posttraumatic intracranial hypertension.

RECENT FINDINGS: An evidence-based review resulted recently in the publication of Guidelines for Surgical Management of Traumatic Brain Injury. Unfortunately all published surgical studies are at the level of simple options with no standards. We know that a number of patients harbouring small epidural/subdural hematomas can be managed conservatively when the lesions are less than 10 mm of thickness and with a midline shift of less than 5 mm.

With exception of these few cases, the current practice is that a large number of patients with posttraumatic hematomas are operated either within 24 h from injury (with acute subdural hematomas as the prevailing lesion) or later (with parenchymal hematomas as the prevailing lesion). According to a recent European study, about one third of these patients are also decompressed.

SUMMARY: A surgical approach is frequent in posttraumatic intracranial hematomas in spite of a low level of evidence. One of the surgical options either in association with hematoma evacuation or in isolation is the technique of bone flap decompression.