The EUROTHERM trial tested therapeutic hypothermia for raised intracranial pressure after traumatic brain injury and stopped early after evidence of harm. This 2015 appraisal examines neurological outcomes, trial design and why the timing and position of cooling within an escalation strategy matter when interpreting the results.
JC: EuroTHERM or EuroBURNED. St.Emlyn’s Read More
Highlights from the 2015 neuroanaesthesia and critical care meeting in Manchester, with a focus on collaboration around traumatic brain injury. Dan Horner reflects on variation in practice, fatigue and situational awareness, specialist intensive care, tracheostomy safety and communication with patients who experience awareness during anaesthesia.
Neurocritical care in Manchester NASGBI and St.Emlyn’s Read More
Why did progesterone’s promise in experimental brain injury fail to translate into benefit in a large clinical trial? This 2014 journal club examines patient selection, randomisation, anticipated treatment effects and stopping for futility, using the study to explore the challenges of translating laboratory findings into patient care.
JC: Progesterone’s pleiotropic failure in head injury. St.Emlyn’s Read More
Iain Beardsell and neurointensive care consultant John Hell discuss diffuse axonal injury in this 2014 podcast. Using a hypothetical injured cyclist, they explore the underlying mechanisms, why initial imaging may reveal little, the evolution of secondary injury and the difficulty of predicting recovery for an individual patient.
Podcast – Diffuse Axonal Injury with John Hell Read More
Can CT measurements identify which older patients with acute subdural haematoma need neurosurgical referral? This 2014 journal club examines a proposed decision tool, questioning selection bias, measurement reliability and how a ‘surgical’ bleed was defined, and explaining why promising retrospective findings still need validation.
JC: When a subdural needs surgery in the elderly. St. Emlyn’s Read More
How common is pituitary dysfunction after serious head injury, and what should clinicians do about it? This 2014 journal club reviews a meta-analysis of patients requiring critical care, distinguishing evidence of endocrine abnormalities from unanswered questions about screening, treatment and outcomes.
JC: Anterior pituitary disorder following head injury Read More
A contemporary review of NICE’s January 2014 head-injury guideline, CG176. The post explores what changed for emergency clinicians, including CT decisions in adults and children, anticoagulation, cervical spine imaging and discharge information, while discussing the evidence and uncertainties behind the recommendations.
JC: Updated NICE Head Injury Guidelines – Worth a Scan? Read More
How should clopidogrel use influence assessment after a head injury? This 2012 journal club examines a prospective cohort study of intracranial bleeding, questioning comparisons with warfarin, patient selection and whether CT findings adequately capture the outcomes that matter to patients.
JC: Clopidogrel + head injury = CT? Read More
