Introduction to Traumatic Brain Injury

Explore the pathophysiology and management of traumatic brain injury in this comprehensive video lecture by Dr. Lisa DelSignore for OPENPediatrics. Delve into the underlying mechanisms of cerebral swelling, learn strategies for managing increased intracranial pressure, and discover techniques for optimizing cerebral perfusion pressure in TBI patients. Gain insights into typical causes of TBI, including high-speed motor vehicle accidents and non-accidental trauma, and understand the various types of intracranial bleeding associated with these injuries. Examine the differences between primary and secondary brain injuries, with a focus on preventing secondary damage through proper management. Study the development of cerebral edema, its peak occurrence timeline, and the mixed vasogenic and cytotoxic components involved. Learn about autoregulation, the effects of hypoxia on cerebral blood flow, and the relationship between ischemic duration and cerebral blood flow. Explore practical management strategies for TBI patients, including optimizing sedation and paralysis, implementing hyperosmolar therapy, and creating osmolar gradients to lower intracranial pressure.

Intro
Typical Traumatic Brain Injury (TBI)
Cerebral Edema Development • Peak swelling occurs within 2-3 days post-injury
Managing Cerebral Perfusion Pressure
Autoregulation
Increasing CBF with Hypoxia
Ischemic Duration vs. CBF
Optimizing CPP • Strategies to lower ICP
Management of Patient with TBI
Optimizing Sedation and Paralysis
Hyperosmolar Therapy • Goal: creation of osmolar gradient