SCCM Resource Library-Bulletproof Solutions to Challenges and Controversies in Penetrating Traumatic Brain Injury

Video Transcription

Video Summary

The speakers discussed the topic of penetrating traumatic brain injury (TBI) and the challenges in managing these cases. They highlighted that TBI from gun violence is becoming more common and is particularly prevalent among young individuals. Despite the severity of gunshot wounds to the head, some patients have shown good outcomes. The speakers presented a comprehensive panel of experts to discuss controversies and challenges in the treatment of these patients.<br /><br />The ballistics and pathophysiology of penetrating TBI were discussed. It was emphasized that the caliber and velocity of the bullet determine the extent of damage. The temporary cavity created by the bullet can cause significant destruction of the tissue, resulting in a track of injury that is much larger than the bullet itself. The speakers also highlighted the high incidence of intracranial vascular injury in penetrating TBI cases.<br /><br />Surgical intervention was discussed as an option in managing penetrating TBI. The speakers emphasized the importance of timely and efficient surgery to achieve good outcomes. Factors such as the trajectory of the bullet, pupillary response, and the presence of mass lesions were identified as predictive factors of outcomes. The speakers also discussed the challenges in prognosticating for penetrating TBI and the need to consider patient-reported outcomes in assessing functional outcomes.<br /><br />In conclusion, the speakers highlighted the complexity and challenges in managing penetrating TBI cases. They emphasized the need for multidisciplinary collaboration and the importance of individualized approaches in these cases. Further research and the development of guidelines are needed to improve outcomes for patients with penetrating TBI.

Asset Subtitle

Trauma, 2020

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2020 Critical Care Congress held February 16-19, 2020, in Orlando, Florida, USA.

Learning Objectives

Explain the mechanisms by which missiles cause primary and secondary brain injury and formulate an individualized and prioritized approach to the initial management and stabilization of patients with penetrating traumatic brain injury
Describe the complex peri- and postoperative issues encountered in managing patients with penetrating traumatic brain injury
Describe the limitations in the literature regarding the management of these issues
Choose the most appropriate treatment strategy within this context
Illustrate the potential pitfalls in prognosis

Bullet to the Brain: Ballistics, Pathophysiology, and Initial Management of Penetrating Traumatic Brain Injury

Fernando D. Goldenberg

Managing the Shattered Skull: Complex Neurosurgical Problems in Penetrating Traumatic Brain Injury

Monisha A. Kumar

Neurosurgical Management in Penetrating Brain Injury

Peleg M. Horowitz

Prognosis in Penetrating Traumatic Brain Injury: Is There a Magic Bullet to See Into the Crystal Ball?

Deborah Stein

Meta Tag

Content Type Presentation

Knowledge Area Trauma

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Traumatic Brain Injury TBI

Tag Neurotrauma

Year 2020

Keywords

penetrating traumatic brain injury

TBI

gun violence

good outcomes

ballistics

intracranial vascular injury

surgical intervention

predictive factors

patient-reported outcomes

multidisciplinary collaboration

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