1. The role of a neurosurgeon in caring for patients with traumatic brain injury
Kevin Yoo M.D.

2. Traumatic brain injury
Major cause of disability and death
Is head injury = traumatic brain injury?

3. Acute care Surgery Monitoring Subdural Hematoma Epidural Hematoma
Cerebral Contusions
Cerebral Edema
Monitoring
Intracranial Monitors
Can you change this picture to one of surgery for TBI?

4. Glasgow Coma Score Eye Verbal Motor Perfect score: 15
1: Does not open eyes
2: Opens eyes to pain
3: Opens eyes to voice
4: Spontaneously opens eyes
Verbal
1: No speech
2: Incomprehensible noise
3: Incomprehensible words
4: Confused
5: Normal
Motor
1: No movement
2: Decorticate posturing
3: Decerebrate posturing
4: Withdraws to pain
5: Moves spontaneously
6: Moves purposefully
Perfect score: 15
Most PI patients will be 14
Even at 14 or 15, have TBI

5. Why does normal patient have tbi?
Why does normal patient have tbi?--- What does this mean it does not make sense

6. In Hospital care For severe TBI For mild to moderate TBI
Monitor for brain swelling
Medications and CSF Drainage
May need additional surgery such as decompressive craniectomy
Eventually to rehab.
For mild to moderate TBI
Discharge soon or after patient has controlled or no symptoms
Please add appropriate picture here.

7. Outpatient care Post-concussive syndrome Care: Self-limiting Time
Pain medications
Rest
Physical Therapy
Cognitive Therapy
Occipital Nerve Stimulator

8. Post concussive syndrome
These are not post concussive syndrome. Can you make me a slide of that?

9. How does a neurosurgeon help with PI tbi?
Evaluation and Report
Diagnose TBI and PCS
MRI Brain with Brain Injury Protocol
THIS IS KEY!
Objective evidence of brain injury

10. MRI with TBI Protocol Imaging Healthcare Specialist
Advanced neuroimaging techniques
Diffusion Tensor Imaging (DTI)
Looks at fiber tracks
Susceptibility weighted Imaging (SWI)
Looks for micro-bleeds
MRI Spectroscopy (MRS)
Looks for chemical composition of brain issue