PRESENTATION
The idea of NEUROTRAUMABRASIL was born and settled along the experience of several neurotraumatologists colleagues in the period when they were collaborating members of the trauma and intensive care department of the Brazilian Society of Neurosurgery. We believe that the interaction between the various specialties that deal with the TRAUMA phenomenon, in its various aspects, can contribute to improve the care of the polytraumatized patient in general. This is a space for VIRTUAL discussion, not intending to dispute or claim space with any Society of Specialty.
Therefore, NEUROTRAUMABRASIL was created to provide an independent discussion on TRAUMA, without political ties, with the objective of:
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Exchange experiences;
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Offer an alternative location for this virtual community to seek up-to-date information;
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Propose solutions for these patients that meet the local needs of each particular region;
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Integrate medical specialty and related professionals into a unique community.
To manage the various objectives mentioned under main objectives, we have created several working groups, where members donate part of their time voluntarily.
THE PROBLEM
Trauma is a national endemic, whose levels are on the rise. Neurotrauma is only one facet of trauma and polytrauma patients. Severe traumatic brain injury (TBI) is diagnosed worldwide when the patient reaches a score of 8 or less on the Glasgow coma scale. It is a major cause of morbidity and mortality, particularly in young men. The sequelae associated with severe TBI are functional, social and economic.
Clinical and experimental findings in the last three decades indicate that brain injury is caused not only by impact (primary injury), but also by a process that succeeds primary injury, starting hours and days after the initial trauma (secondary injury).
With the exception of prevention, there are not many approaches to be adopted in order to minimize primary injury, in such a way that the approach to the problem should focus on the prevention and treatment of secondary injuries. Secondary lesions can result from intracranial causes (lesions with mass effect, focal or diffuse brain swelling, intracranial hypertension, seizures, vasospasm or infection) and / or extracranial causes (arterial hypotension - systolic BP <90mmHg, hypoxia, hyper / hypocapnia, hyper / hypoglycemia, anemia, pyrexia, hydroelectrolytic disorders, coagulopathy and infections). The result is cerebral ischemia, energy failure, inflammation, oxidative stress and, finally, neuronal death.
To prevent or treat secondary brain injury, it is currently recommended to maintain target cerebral perfusion pressure (CPP)> 60mmHG, euvolemia and normoventilation, whenever possible, in order to improve cerebrovascular hemodynamics. Specific interventions such as analgesia, sedation, CSF drainage, controlled hyperventilation, osmotherapy (mannitol and / or hypertonic saline), decompressive craniectomy, barbiturate coma and therapeutic hypothermia have their place and the right time to be used.
The approach to this public health problem must be multidisciplinary in its various aspects. We live in a country of continental, economically and culturally heterogeneous dimensions, where neighboring states in the Federation differ widely in the services offered to the population, affecting the provision of health services.
OBJECTIVE
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To promote interaction between NEUROCIRURGIA and the various medical specialties involved in TRAUMA care.
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To create and maintain an agile source of information for the Brazilian neurosurgical community and related specialties about the procedures and behaviors adopted (approved) by the international neurosurgical community.
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To create and maintain possibilities for continuous research via the Internet through multicentric studies of trauma-related pathologies.
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Create and maintain an agile source of information for the neurosurgical community and related specialties about scientific advances and publications that may affect us as neurosurgeons, neurointensivists and emergencies.
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Collaborate in the development of new methodologies or technologies in the TRAUMA segment.