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Management of traumatic brain injury (TBI): a clinical neuroscience-led pathway for the NHS.

Authors :
Li LM
Dilley MD
Carson A
Twelftree J
Hutchinson PJ
Belli A
Betteridge S
Cooper PN
Griffin CM
Jenkins PO
Liu C
Sharp DJ
Sylvester R
Wilson MH
Turner MS
Greenwood R
Source :
Clinical medicine (London, England) [Clin Med (Lond)] 2021 Mar; Vol. 21 (2), pp. e198-e205.
Publication Year :
2021

Abstract

Following hyperacute management after traumatic brain injury (TBI), most patients receive treatment which is inadequate or inappropriate, and delayed. This results in suboptimal rehabilitation outcome and avoidable detrimental chronic effects on patients' recovery. This worsens long-term disability, and magnifies costs to the individual and society. We believe that accurate diagnosis (at the level of pathology, impairment and function) of the causes of disability is a prerequisite for appropriate care and for accessing effective rehabilitation. An expert-led, integrated care pathway is needed to deliver accurate and timely diagnosis and optimal treatment at all stages during a TBI patient's care.We propose the introduction of a specialist interdisciplinary traumatic brain injury team, led by a neurosciences-trained brain injury consultant. This team would engage acutely and for a longer term after TBI to provide accurate diagnoses, which guides subsequent management and rehabilitation. This approach would also encourage more efficient collaboration between research and the clinic. We propose that the current major trauma network is leveraged to introduce and evaluate this proposal. Improvements to patient outcomes through this approach would lead to reduced personal, societal and economic impact of TBI.<br /> (© Royal College of Physicians 2021. All rights reserved.)

Details

Language :
English
ISSN :
1473-4893
Volume :
21
Issue :
2
Database :
MEDLINE
Journal :
Clinical medicine (London, England)
Publication Type :
Academic Journal
Accession number :
33762387
Full Text :
https://doi.org/10.7861/clinmed.2020-0336