Head Injury Management at UAB
Few injuries or illnesses are as devastating to an individual and their family as a severe brain or spinal injury. The Neurosurgery service at UAB and the Children's Hospital of Alabama are committed to providing world class service to patients who have suffered these injuries and their families. This occurs on multiple levels. First, in approaching the acutely injured patient we take primary and complete responsibility for managing the variables that can absolutely minimize any component of secondary injury. Secondary injury refers to the cascade of biochemical and physiological changes that occur in a delayed fashion (beyond the moment of impact or injury). The cardinal parameters that are involved are the control of intracranial pressure and the assurance of perfusion pressure. Intracranial pressure refers to the pressure inside of the cranium (skull) that often rises as injured tissues swell and occupy more space. The elevation of pressure can make it more difficult for blood to perfuse the brain as well and it is from this principle that the commitment to maintaining cerebral perfusion pressure arises. All severely head injured patients are managed by the Neurosurgery service. We work cooperatively with our colleagues in Trauma, General, Cardio-thoracic, Pediatric and Orthopedic Surgery as well as Critical Care Intensivists to insure meticulous comprehensive care of the multiply injured patient however the primary management of issues related to brain injury are managed by the Neurosurgical service.
UAB Neurosurgery is one of the busiest neuro-trauma services in the nation. Over 400 patients are treated each year and the average daily census of head injured patients is 12-15. Once the acute situation is improved we work cooperatively with colleagues in Physical Medicine and Rehabilitation who run the UAB Head Injury Rehabilitation Program.