Podcasts

Traumatic Brain Injury

November 22, 2019
Dr. Pramod Puligandla, Traumatic Pediatric Surgeon and Intensivist at Montreal Children’s Hospital, joins the Stay Current Team to review the Cliff Notes on traumatic brain injury (TBI).

Sections

  • Background (00:00)
  • Clinical case: A 15 year old male presents to your ED after being hit in the head by a line drive ball during the 3rd inning of his baseball game. (00:32)
  • Initial management and considerations in this patient? (01:02)
  • Intracranial hypertension (01:53)
  • Clinical presentation of intracranial hypertension (02:53)
  • Management of intracranial hypertension (03:17)
  • Hypertonic saline versus mannitol (04:00)
  • Blood pressure goals (05:00)
  • Role for steroids? (06:30)
  • Other management options when conservative management fails? (06:52)
  • When to consider repeat CT versus MRI? (08:55)
  • Clinical case continued: Development of sympathetic storming (10:38)
  • Cause and presentation of sympathetic storming (10:52)
  • Lack of treatment of sympathetic storming (11:18)
  • Treatment: Sedation and pain control (12:13)
  • Clinical pearls (13:15)