To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This chapter discusses the diagnosis, evaluation and management of intracranial hemorrhage. It describes types of intracranial hemorrhage, including subarachnoid hemorrhage (SAH), subdural hemorrhage (SDH), epidural hemorrhage (EDH) and intracerebral hemorrhage (ICH). Emergent non-contrast head CT is the cornerstone for detection of ICH. MRI is equally effective in identifying ICH and better at detecting predisposing underlying parenchymal or vascular anomalies. Emergency department management focuses on protecting cerebral perfusion by balancing the forces of mean arterial pressure (MAP) and intracranial pressure (ICP). Patients should be positioned with the head of the bed elevated to 30 degrees to support cerebral venous drainage to reduce ICP. The main goal of emergency management is to temporize ICP changes, avoid secondary insults (e.g., hypoxia and hypotension) and protect cerebral perfusion pressure (CPP) while expediting neurosurgical evaluation for possible life-saving surgical intervention.
This chapter discusses the pathophysiology and critical management of spinal cord trauma. It describes the most common and significant injuries to the spinal cord. Penetrating injuries can result in a complete or partial spinal cord transection. Following the immediate trauma, secondary injury can occur to the spinal cord within minutes to hours. The mechanisms of secondary injury to the spinal cord include hypoxia, ischemia, inflammation, edema, necrosis, electrolyte and ion disturbances, excitotoxicity and apoptosis. Early intubation is considered for all patients with cervical spinal cord injuries who demonstrate any signs of inadequate ventilation or oxygenation in order to minimize secondary spinal cord injuries. Care should be taken during the intubation of patients with cervical spine injuries to minimize any movement of the neck that may cause worsening of the injury. The use of airway adjuncts, such as video laryngoscopy or fiberoptic techniques, may be preferable to direct laryngoscopy.