The essence of acute CNS injury management is to minimize secondary injury related to hypoxia, hypoperfusion, & further mechanical damage (such as evacuating a subdural hematoma causing mass effect & herniation).
Acute spinal cord injury management involves:
- Spine immobilization.
- Airway management if necessary.
- Maintaining spinal cord perfusion (which may be exacerbated by traumatic hemorrhage and/or spinal shock).
- Surgical intervention to relieve spinal cord compression and/or vertebral deformities.
Acute brain injury management focuses on:
- Airway management.
- Cervical spine immobilization (due to the high frequency of concomitant head & neck injuries).
- Maintaining cerebral perfusion.
- Medical therapies to control symptomatic brain edema (hyperventilation, hyperosmotic therapy).
- Surgical intervention to place ventricular drains/intracranial pressure monitors, remove foreign objects, fix skull deformities, or to relieve brain compression (for example- hematoma removal, hemicraniectomy).
