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神经保护:创伤性脑损伤的手术方法

Neuroprotection: Surgical approaches in traumatic brain injury.

作者信息

Buccilli Barbara, Alan Albert, Aljeradat Baha' Ghandi, Shahzad Akmal, Almealawy Yasser F, Chisvo Nathan Simbarashe, Ennabe Michelle, Weinand Martin

机构信息

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, New York, United States.

Global Neurosurgical Alliance, United States.

出版信息

Surg Neurol Int. 2024 Jan 26;15:23. doi: 10.25259/SNI_774_2023. eCollection 2024.

Abstract

BACKGROUND

This review is centered on the pivotal role of surgical interventions within the comprehensive management of traumatic brain injury (TBI). Surgical strategies are indispensable components of TBI care, encompassing primary injury management and the alleviation of secondary injury processes, including the handling of intracranial hemorrhages (ICHs), contusions, and mass lesions.

METHODS

A systematic review was carried out by searching databases including PubMed, Embase, and Scopus. The inclusion criteria involved studies discussing surgical strategies for TBI, with a focus on primary injury management, ICHs, contusions, and mass lesions. More recent articles were prioritized, and data were synthesized to assess the impact of surgical interventions on TBI outcomes.

RESULTS

The evolution of surgical technologies has heralded a transformation in TBI management. These advancements encompass minimally invasive procedures, neuroimaging-guided surgeries, and robotic-assisted techniques, all geared toward optimizing patient outcomes.

CONCLUSION

Surgical interventions within TBI care present unique challenges, such as timing considerations, patient selection criteria, and postoperative care. This review underscores the critical significance of multidisciplinary collaboration among neurosurgeons, neurologists, and critical care specialists. Such collaboration is essential to tailor surgical strategies to the individualized needs of patients. Moreover, the review highlights emerging trends in TBI surgery and underscores the ongoing imperative of research endeavors aimed at refining surgical protocols and ultimately enhancing patient outcomes.

摘要

背景

本综述聚焦于手术干预在创伤性脑损伤(TBI)综合管理中的关键作用。手术策略是TBI治疗不可或缺的组成部分,包括原发性损伤管理以及减轻继发性损伤过程,其中涵盖颅内出血(ICH)、挫伤和占位性病变的处理。

方法

通过检索包括PubMed、Embase和Scopus在内的数据库进行系统综述。纳入标准包括讨论TBI手术策略的研究,重点关注原发性损伤管理、ICH、挫伤和占位性病变。优先纳入更新的文章,并综合数据以评估手术干预对TBI预后的影响。

结果

手术技术的发展预示着TBI管理的变革。这些进步包括微创手术、神经影像引导手术和机器人辅助技术,所有这些都旨在优化患者预后。

结论

TBI治疗中的手术干预存在独特挑战,如时机考量、患者选择标准和术后护理。本综述强调了神经外科医生、神经科医生和重症监护专家之间多学科协作的至关重要性。这种协作对于根据患者的个体化需求制定手术策略至关重要。此外,该综述突出了TBI手术的新兴趋势,并强调了持续进行研究以完善手术方案并最终改善患者预后的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3ee/10858784/5cea829e2e87/SNI-15-23-g001.jpg

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