Traumatic Brain Injury ( Tbi ) - 862 Words

Traumatic brain injury (TBI) affects 1.7 million people annually in the U.S. with 275,000 hospitalizations and 52,000 deaths. In 2010, the medical cost for treating TBI patients in the U.S. was $76.5 billion and rising annually. Primary causes for TBI include the following: motor vehicle crashes, falls, assaults and sports or recreation-related injuries (concussions). Finding the right treatment to reduce mortality rates and improve the clinical outcomes in TBI patients has been elusive. Professor Leslie Matthews of Morehouse School of Medicine is a trauma surgeon who treats TBI patients. He and his colleagues have just published a case series of a new successful treatment of TBI. Matthews LR, Danner OK, Ahmed YA, Dennis-Griggs DM,†¦show more content†¦Her physical exam was notable for a blood pressure of 105/56 mmHg, pulse of 87 beats/min, temperature of 37.7 C, respiratory rate of 20/min, and oxygen saturation of 100% on the ventilator. Her secondary survey revealed unequal pupils with discordant reactivity. Her right pupil was 8 mm and non-reactive to light and her left pupil was 3 mm and reactive to light. Ominously, she was noted to have decerebrate posturing (indicating severe brain damage) of both the upper and lower extremities bilaterally. On further examination, a five cm laceration to the right lower anterior thigh was identified and repaired. Her Focused Assessment Sonogram for Trauma (FAST) exam was negative. The initial computed tomography (CT) scan of her head revealed multifocal, punctuate brain hemorrhages, consistent with a diffuse axonal injury (DAI). (Figure 1) CT scans of the cervical spine, chest, abdomen, and pelvis revealed bilateral spinous process fractures of C7, T1, and T2, a mid sternal body fracture, bilateral pulmonary contusions, and a distal right clavicle fracture. She also sustained a cardiac contusion associated post-injury arrhythmias, which were treated conservatively. An external ventricular drainage device was placed by neurosurgery to help monitor and manage her intracranial pressure and maintain her cerebral perfusion pressure within acceptable limits. Upon her admission to the surgical