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Editors
Stephen Honeybul and Angelos G. Kolias

Traumatic Brain Injury

Science, Practice, Evidence and Ethics
1st ed. 2021
Editors
Stephen Honeybul
Department of Neurosurgery, Sir Charles Gairdner and Royal Perth
Hospitals, Perth, WA, Australia

Angelos G. Kolias
Division of Neurosurgery, Department of Clinical Neurosciences,
University of Cambridge and Addenbrooke’s Hospital, Cambridge, UK

ISBN 978-3-030-78074-6 e-ISBN 978-3-030-78075-3

https://doi.org/10.1007/978-3-030-78075-3

© Springer Nature Switzerland AG 2021

This work is subject to copyright. All rights are reserved by the

Publisher, whether the whole or part of the material is concerned,
specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in any other
physical way, and transmission or information storage and retrieval,
electronic adaptation, computer software, or by similar or dissimilar
methodology now known or hereafter developed.

The use of general descriptive names, registered names, trademarks,

service marks, etc. in this publication does not imply, even in the
absence of a specific statement, that such names are exempt from the
relevant protective laws and regulations and therefore free for general
use.

The publisher, the authors and the editors are safe to assume that the
advice and information in this book are believed to be true and accurate
at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the
material contained herein or for any errors or omissions that may have
been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer

Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham,
Switzerland
To Louise and Robert (SH)
To Jenny and Johnny (AK)
Preface
It is often stated in the literature that traumatic brain injury TBI is a
silent epidemic with an estimated 64–74 million new cases presenting
each year. It is called silent because the long-term impairments suffered
by many TBI patients, such as memory loss, cognitive dysfunction or
behavioural disturbance, are often not visible. However, there is a
growing realization that robust pre-hospital, acute in-hospital, and
post-acute/long-term care delivered by various disciplines with specific
areas of expertise is paramount to optimize patient outcomes. As
healthcare systems are implementing pathways for managing TBI
patients from the scene of the injury and beyond discharge from the
acute setting, we can be optimistic that the silence will eventually be
broken.
At the same time, the involvement of several disciplines, each
approaching the TBI patient from slightly different angles, poses a
challenge. Different disciplines often use “different languages” and may
approach the same issue in a different way. An appreciation of the key
concepts underpinning TBI management by all disciplines involved is
essential if we are to develop a common “TBI language”.
The present book aims to facilitate the development of a common
“TBI language” by covering key concepts. We have organized it into four
distinct but interrelated parts:
I. Scientific background

II. Current clinical practice

III. Evidence

IV. Ethical considerations

The first part covers topics that TBI books traditionally cover (i.e.
epidemiology, pathophysiology) but we also wanted to touch upon
novel insights generated by new disciplines (e.g. brain mechanics). The
second part covers current clinical practice from the scene of the injury
to long-term rehabilitation. We decided to have separate chapters
discussing the management of TBI in resource-limited settings, as there
is a growing appreciation that when the resources are vastly different, a
“one size fits all” approach (or guideline) for high-income countries
(HICs) and low- and middle-income countries (LMICs) is inappropriate.
The third part is discussing evidence. We are proponents of evidence-
based medicine, but we also appreciate its limitations. Hence, this part
provides a critical appraisal of the evidence underpinning key
interventions (e.g. hypothermia, decompressive craniectomy) and key
aspects of TBI (e.g. long-term neurological consequences). The fourth
and final part is covering ethical considerations. Perhaps there is no
other medical field with so many ethical issues, which is a reflection of
two parameters in the definition of TBI: sudden trauma due to an
external force that causes an alteration of brain functioning.
We would like to thank the authors of all chapters, as without their
time and effort, you would not be holding this book in your hands. We
sincerely hope that this book will contribute to the development of a
common “TBI language” for all disciplines striving to optimize the
outcomes of patients who have been unfortunate to suffer a TBI.

Financial Support
No financial support has been required for this research.

Conflict of Interest
None declared.
Stephen Honeybul
Angelos G. Kolias
Perth, WA, Australia
Cambridge, UK
Acknowledgements
We would like to thank the authors of all chapters for their efforts in
preparing some excellent content despite the Covid-19 pandemic,
which has been a huge challenge for everyone. We also thank the
Springer staff for their support in completing this book. We hope that
you will enjoy reading it and that you will suggest it to your colleagues.
If you would like to get in touch with comments or suggestions, please
feel free to email us at [email protected] and
[email protected].
Contents
Part I Scientific Background
1 Epidemiology of Traumatic Brain Injury
Corrado Iaccarino, A. Gerosa and E. Viaroli
2 Pathophysiology of Traumatic Brain Injury
Katherine R. Giordano and Jonathan Lifshitz
3 Mechanics of Brain Tissue Deformation and Damage Following
Trauma
Michael Sutcliffe and Shijia Pan
4 Evidence Pyramid, Comparative Effectiveness Research, and
Randomised Trials
Kwok M. Ho
5 Big Data Collection and Traumatic Brain Injury
Rianne G. F. Dolmans, Brittany M. Stopa and Marike L. D. Broekman
Part II Current Clinical Practice
6 Prehospital and Emergency Department Management of TBI
David J. Barton and Francis X. Guyette
7 Monitoring the Injured Brain
Enza La Monaca, Orazio Mandraffino, Deepak Gupta and
Anna Teresa Mazzeo
8 Contemporary Medical Management of Traumatic Brain Injury:​
High-Income Countries
Marcel Aries and Gerrit Schubert
9 Contemporary Management of Traumatic Brain Injury:​Low and
Middle-Income Countries
Andrés M. Rubiano and Jeffrey V. Rosenfeld
10 Contemporary Surgical Management of Traumatic Brain Injury
Wellingson Silva Paiva, Davi J. Fontoura Solla and Stephen Honeybul
11 Military Management of Traumatic Brain Injury
Brian P. Curry, Michael Cirivello, Melissa Meister, Jeffrey V. Rosenfeld
and Randy S. Bell
12 Contemporary Management of Paediatric Head Injuries
Snigdha Saha and Stephen Honeybul
13 Sports-Related Traumatic Brain Injury
Niklas Marklund
14 Rehabilitation After Traumatic Brain Injury
H. Mee, L. M. Li and F. Anwar
Part III Evidence
15 Predicting Outcome Following Traumatic Brain Injury
Kwok M. Ho
16 Biomarkers in Traumatic Brain Injury
Jussi P. Posti and Olli Tenovuo
17 Erythropoietin, Progesterone, and Amantadine in the
Management of Traumatic Brain Injury:​Current Evidence
Davi Jorge Fontoura Solla and Wellingson Silva Paiva
18 Tranexamic Acid in the Management of Traumatic Brain Injury
Omar K. Bangash, Kwok M. Ho and Stephen Honeybul
19 Hypothermia in the Management of Traumatic Brain Injury
Stephen Honeybul
20 Decompressive Craniectomy in the Management of Traumatic
Brain Injury
Sara Venturini, Peter Hutchinson and Angelos G. Kolias
21 Cranioplasty Following Traumatic Brain Injury
Stephen Honeybul
22 Thromboembolic Prophylaxis in Traumatic Brain Injury
Kwok M. Ho and Stephen Honeybul
23 Long-Term Neurological Consequences of Traumatic Brain
Injury
Stephen Honeybul
24 Post-Traumatic Epilepsy
L. G. Viswanathan, Harsh Deora, Ajay Asranna and
Andrés M. Rubiano
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