Severe TBI Guidelines
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Penetrating TBI Guidelines
Foreword
I
Disclaimer of Liability
II
Conflict of Interest Disclosure
III
Acknowledgements
IV
Introduction
V
Methodology
VI
Prehospital and Emergency Care Evidence-based Recommendations and Expert Consensus Statements
VI-1
Airway Management
VI-2
Resuscitation Strategies
VI-3
Diagnosis of pTBI Exam, Biomarkers, Imaging
VI-4
Screening When No Obvious Skull Penetration
VI-5
Diagnosis of pTBI Patient Characteristics
VI-6
Imaging of Neurovascular Injury in pTBI
VI-7
Prediction Models
VI-8
Safety of MRI
VII
Surgical Evidence-based Recommendations and Expert Consensus Statements
VII-1
Urgency of Neurosurgery
VII-1A
Immediate Surgery vs. Observation
VII-1B
Delaying for Better Operative Conditions
VII-2
Local Debridement and Closure
VII-3
Extent of Debridement
VII-3A
Radical vs. Conservative Debridement
VII-3B
Retained Bone or Metal Fragments
VII-4
Prevention of Cerebrospinal Fluid Leaks
VII-5
Intraoperative Cultures
VII-6
Management of Traumatic Pseudoaneuryms
VII-7
Penetrating Venous Sinus Injury
VII-8
Timing of Cranioplasty
VII-9
Multidisciplinary Surgical Care
VIII
Intensive Care Evidence-based Recommendations and Expert Consensus Statements
VIII-1
Coagulopathy and Viscoelastic Testing
VIII-2
Intracranial Pressure and Cerebral Perfusion Pressure
VIII-3
Seizure Prophylaxis
VIII-4
Antibiotic Prophylaxis
VIII-5
Venous Thromboembolism Prophylaxis
VIII-6
Timing of Organ Donation
VIII-7
Rehabilitation
IX
Clinical Treatment Algorithms
IX-1
Introduction
IX-2
Methods
IX-3
Master Care Pathway
IX-4
Futility Assessment Toolkit
IX-5
Surgical Management Toolkit
IX-6
Protruding Foreign Body Toolkit
IX-7
Severe Injury (Multiple Lobes Injured/Mass Lesion/Midline shift/Edema) Toolkit
IX-8
Penetrating Skull Base Injury Toolkit
IX-9
Traumatic Vascular Injury Toolkit
X
Appendices
XI
Supplementary Material