Ian Maconochie1, Mark Ross. 1. Department of Paediatric Accident and Emergency, St Mary's Hospital, London, UK.
Abstract
INTRODUCTION: Head injury in young adults is often associated with motor vehicle accidents, violence, and sports injuries. In older adults it is often associated with falls. Severe head injury can lead to secondary brain damage from cerebral ischaemia resulting from hypotension, hypercapnia, and raised intracranial pressure. Severity of brain injury is assessed using the GCS. While about a quarter of people with severe brain injury (GCS score less than 8) will make a good recovery, about a third will die, and a fifth will have severe disability or be in a vegetative state. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to reduce complications of moderate to severe head injury as defined by Glasgow Coma Scale? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 17 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, anticonvulsants, corticosteroids, hyperventilation, hypothermia, and mannitol.
INTRODUCTION:Head injury in young adults is often associated with motor vehicle accidents, violence, and sports injuries. In older adults it is often associated with falls. Severe head injury can lead to secondary brain damage from cerebral ischaemia resulting from hypotension, hypercapnia, and raised intracranial pressure. Severity of brain injury is assessed using the GCS. While about a quarter of people with severe brain injury (GCS score less than 8) will make a good recovery, about a third will die, and a fifth will have severe disability or be in a vegetative state. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to reduce complications of moderate to severe head injury as defined by Glasgow Coma Scale? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 17 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, anticonvulsants, corticosteroids, hyperventilation, hypothermia, and mannitol.
Authors: H M Eisenberg; H E Gary; E F Aldrich; C Saydjari; B Turner; M A Foulkes; J A Jane; A Marmarou; L F Marshall; H F Young Journal: J Neurosurg Date: 1990-11 Impact factor: 5.115
Authors: J P Muizelaar; A Marmarou; J D Ward; H A Kontos; S C Choi; D P Becker; H Gruemer; H F Young Journal: J Neurosurg Date: 1991-11 Impact factor: 5.115