TRAUMATISMO CRANEOENCEFÁLICO EN NEUROINTENSIVO 2004-2005

Leonardo de Jesús Barrios; Juan Carlos Núñez; Jose Walter Valverde

Enviado octubre 12, 2024

Publicado 2026-04-06

Artículos de Investigación

Vol. 20 Núm. 1 (2007): Revista Médico Científica

TRAUMATISMO CRANEOENCEFÁLICO EN NEUROINTENSIVO 2004-2005

Leonardo de Jesús Barrios⁺⁻
Juan Carlos Núñez⁺⁻
Jose Walter Valverde⁺⁻

PDF

Citación:

DOI: ND

Publicado: 2026-04-06

Derechos de autor 2024 Revista médico científica

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Resumen

Introducción: Los traumas son causa de muerte, más del 50 % por traumatismo craneoencefálico. El 75 % de los severos presentan un hematoma intracranial. Una evaluación médica, radiológica y un tratamiento oportuno mejoran el pronóstico.

Objetivos: Describir las características y evaluar el manejo del paciente con Traumatismo Craneoencefálico en las unidades de Cuidados Intensivos. Diseño Metodológico: Estudio Cohorte analitico longitudinal prospectivo, entre noviembre 2004 y julio 2005. Se analizaron características epídemiológicas, factores asociados y mortalidad. Significancia estadística: valor de p y relaciones: riesgo relativo e intervalos de confianza al 95%.

Resultados: Edad promedio 39.7±14.4, M-F 7:1 y noche-día 3:1. Lesiones más frecuentes: Hemorragia Subaracnoidea, Hematoma. Subdural y Hematoma Intracerebral, 31 % cada una. Doppler transcraneal 88% y profundidad de sedación 81 %. En severos, 90% sensor de presión intracraneala con aumento de velocidades de flujo en cerebral medi~. El 62% fueron severos, 19% moderados y 19% leves. El 56% a sala. Relación severidad de trauma y mortalidad 3.6 (1.4-9.4), hipertensión endocraneana y mortalidad 3.3 (1.3-8.7), fractura de bóveda craneal y mortalidad 1.9 (1.03-4.99) Y hematoma intracerebral y mortalídad 1.52(1.08-3.97).

Conclusiones: El monitoreo multimodal identifica eventos que aumentan la letalidad, enfocando el manejo a esas complicaciones.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Brain Trauma Foundation. Early indicators of prognosis in severe traumatic brain injury. J Neurotrauma 2000;
:535-627
Caroli M, Locatelli M, Campanella R, Gennarelli T, Thibault L. Multiple intracranial lesions in head injury: Clinical
considerations, prognostic factors, management and results in 95 patients. Surg Neurol 2001; 56:82-88
Coplin W, Cullen N, Policherla P, Adams J. Safety and feasibility of craniectomy with duraplasty as the initial
surgical intervention for severe traumatic brain injury. J Trauma 2001; 50,1050-1059
De Luca G, Volpin L, Fornezza U, Sauquillo-Barris J, LaMarca-Ciuro J. The role of decompressive craniectomy
in the treatment of uncontrollable posttraumatic intracranial hypertension. Acta Neurochir 2000; 76(Suppl): 401-404
Lobato R, Gomez P, Alday R, Kelly J, Rosenberg J. Sequential computerized tomography changes and
related final outcome in severe head injury patients. Acta Neurochir 1997; 139: 385-391
Mandera M, Zralek C, Krawczykl, Gurdjian E. Surgery or conservative treatment in trau matic intracerebral
haematoma. Childs Nerv Syst 1999; 15: 267-9
Meier U, Zeilinger F, Henzka O. The use of decompressive craniectomy for the management of severe head injuries. Acta Neurochir 2000; 76(Suppl): 475-478
Munch E, Horn P, Schurer L, Valadka A. Management of severe traumatic brain injury by decompressive
craniectomy. Neurosurgery 2000; 47: 315-322
Patel N, Hoyt D, Nakaji P, Yarnell P, Saunders R. Traumatic brain injury: Patterns of failure of nonoperative management. J Trauma 2000; 48: 367-374
Polin R, Shaffrey M, Bogaev C, McCrory P. Decompressive bifrontal craniectomy in the treatment of severe refractory posttraumatic cerebral edema. Neurosurgery 1997; 41: 84-92
Servadei F, Murray G, Penny K, Sault T, Ducker T. The value ofthe "worst" computed tomographic scan in clinical
studies of moderate and severe head injury. European Brain Injury Consortium. Neurosurgery 2000; 46: 70-75
Taylor A, Butt W, Rosenfeld J, Bruce D, Juul N, Morris G, et al. A randomized trial of very early decompressive
craniectomy in children with traumatic brain injury and intracranial hypertension. Childs Nerv Syst; 2001; 17:
-162
Whitfield P, Patel H, Hutchinson P. Bifrontal decompressive craniectomy in the management of posttraumatic
intracranial hypertension. Br J Neurosurg 2001; 15: 500-507
Wu J, Hsu C, Liao S, Wong y. Surgical outcome of traumatic intracranial haematoma at a regional hospital
in Taiwan. J Trauma 1999; 47: 39-43
Yoo D, Kim D, Cho K, Tong E, Hui K. Ventricular pressure monitoring during bilateral decompression with dural
expansiono J Neurosurg 1999; 91 :953-959
McCrory P, Berkovic S. Second Impact Syndrome. Neurology 1998; 50: 677-83
Juul N, Morris G, Marshall S. Intracranial Hypertension and Cerebral Perfusion Pressure: Influence on Neurological Deterioration and Outcome in Severe Head Injury. J Neurosurg 2000; 92: 1-6
Unterberg A, Kienning K, Hartl R, Duus B. Multimodal monitoring in patients with head injury: Evaluation of the
effects of treatment on cerebral oxygenation. J Trauma 1997; 42(Suppl 5): 532-537
Prabhu V, Kaufman H, Voelker J, Schacford S. Prophylactic antibiotics with intracranial pressure monitors and external ventricular drains: A review of the evidence. Surg Neurol 1999; 52: 226-237
Diringer M, Yundt K, Videen T, Stein S, Flannagan T. No reduction in cerebral metabolism as a result of early
moderate hyperventilation following severe traumatic brain injury. J Neurosurg 2000; 92: 7-13
Marion D, Letarte P. Management of intracranial hypertension. Contemp Neurosurg 1997; 19(3): 1-6
Riesgo P, Piquer J, Botella C. Delayed extradural haematoma after mild head injury: Report of three cases.
Surg Neuro11997; 48: 226-231

Palabras clave

PDF

Resumen visto - 4 veces
PDF descargado - 1

Licencia

Content Top

[1] Brain Trauma Foundation. Early indicators of prognosis in severe traumatic brain injury. J Neurotrauma 2000;

[2] :535-627

[3] Caroli M, Locatelli M, Campanella R, Gennarelli T, Thibault L. Multiple intracranial lesions in head injury: Clinical

[4] considerations, prognostic factors, management and results in 95 patients. Surg Neurol 2001; 56:82-88

[5] Coplin W, Cullen N, Policherla P, Adams J. Safety and feasibility of craniectomy with duraplasty as the initial

[6] surgical intervention for severe traumatic brain injury. J Trauma 2001; 50,1050-1059

[7] De Luca G, Volpin L, Fornezza U, Sauquillo-Barris J, LaMarca-Ciuro J. The role of decompressive craniectomy

[8] in the treatment of uncontrollable posttraumatic intracranial hypertension. Acta Neurochir 2000; 76(Suppl): 401-404

[9] Lobato R, Gomez P, Alday R, Kelly J, Rosenberg J. Sequential computerized tomography changes and

[10] related final outcome in severe head injury patients. Acta Neurochir 1997; 139: 385-391

[11] Mandera M, Zralek C, Krawczykl, Gurdjian E. Surgery or conservative treatment in trau matic intracerebral

[12] haematoma. Childs Nerv Syst 1999; 15: 267-9

[13] Meier U, Zeilinger F, Henzka O. The use of decompressive craniectomy for the management of severe head injuries. Acta Neurochir 2000; 76(Suppl): 475-478

[14] Munch E, Horn P, Schurer L, Valadka A. Management of severe traumatic brain injury by decompressive

[15] craniectomy. Neurosurgery 2000; 47: 315-322

[16] Patel N, Hoyt D, Nakaji P, Yarnell P, Saunders R. Traumatic brain injury: Patterns of failure of nonoperative management. J Trauma 2000; 48: 367-374

[17] Polin R, Shaffrey M, Bogaev C, McCrory P. Decompressive bifrontal craniectomy in the treatment of severe refractory posttraumatic cerebral edema. Neurosurgery 1997; 41: 84-92

[18] Servadei F, Murray G, Penny K, Sault T, Ducker T. The value ofthe "worst" computed tomographic scan in clinical

[19] studies of moderate and severe head injury. European Brain Injury Consortium. Neurosurgery 2000; 46: 70-75

[20] Taylor A, Butt W, Rosenfeld J, Bruce D, Juul N, Morris G, et al. A randomized trial of very early decompressive

[21] craniectomy in children with traumatic brain injury and intracranial hypertension. Childs Nerv Syst; 2001; 17:

[22] -162

[23] Whitfield P, Patel H, Hutchinson P. Bifrontal decompressive craniectomy in the management of posttraumatic

[24] intracranial hypertension. Br J Neurosurg 2001; 15: 500-507

[25] Wu J, Hsu C, Liao S, Wong y. Surgical outcome of traumatic intracranial haematoma at a regional hospital

[26] in Taiwan. J Trauma 1999; 47: 39-43

[27] Yoo D, Kim D, Cho K, Tong E, Hui K. Ventricular pressure monitoring during bilateral decompression with dural

[28] expansiono J Neurosurg 1999; 91 :953-959

[29] McCrory P, Berkovic S. Second Impact Syndrome. Neurology 1998; 50: 677-83

[30] Juul N, Morris G, Marshall S. Intracranial Hypertension and Cerebral Perfusion Pressure: Influence on Neurological Deterioration and Outcome in Severe Head Injury. J Neurosurg 2000; 92: 1-6

[31] Unterberg A, Kienning K, Hartl R, Duus B. Multimodal monitoring in patients with head injury: Evaluation of the

[32] effects of treatment on cerebral oxygenation. J Trauma 1997; 42(Suppl 5): 532-537

[33] Prabhu V, Kaufman H, Voelker J, Schacford S. Prophylactic antibiotics with intracranial pressure monitors and external ventricular drains: A review of the evidence. Surg Neurol 1999; 52: 226-237

[34] Diringer M, Yundt K, Videen T, Stein S, Flannagan T. No reduction in cerebral metabolism as a result of early

[35] moderate hyperventilation following severe traumatic brain injury. J Neurosurg 2000; 92: 7-13

[36] Marion D, Letarte P. Management of intracranial hypertension. Contemp Neurosurg 1997; 19(3): 1-6

[37] Riesgo P, Piquer J, Botella C. Delayed extradural haematoma after mild head injury: Report of three cases.

[38] Surg Neuro11997; 48: 226-231

Imagen de portada

Resumen

Descargas

Citas

Palabras clave

Licencia