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Study Questions Standard of Care for Head Trauma
Date:12/12/2012

g group and 41 percent in the scans-and-exams group, the study found.

"Within this field, this is a game changer," Chesnut said in a statement.

Chesnut believes the current method of pressure monitoring relies too heavily on specific readouts of pressure, and not on an individual patient's overall condition, while exams and CT scans are better indicators of overall condition.

"We suspect that one major issue is that 20 mm Hg" -- a number that indicates normal intracranial pressure -- "is not a magic number, and that patients require a more complicated method of treatment," Chesnut said.

He added that these results suggest that different methods of monitoring patients should be more commonplace. This could mean more focused treatment, less unnecessary treatment and shorter stays in the intensive-care unit.

In Bolivia and Ecuador, intracranial monitors, which cost $700 or more, are not routinely used, which is why the study was conducted there, Chesnut explained. The U.S. National Institutes of Health funded the study.

Another expert questioned whether using CT scans and repeated exams would be as cost-effective as using intracranial monitors in the United States.

"We need to see whether replacing the device is cost-effective compared with having a neurointensivist analyzing changes and also having CT scans available throughout the day and having support systems available to run those CT scans, plus the cost of the CT scan itself," said Dr. Danny Liang, a neurosurgeon at the Cushing Neuroscience Institute of the North Shore-LIJ Health System in Manhasset, N.Y.

According to the World Health Organization, traumatic brain injury is the leading cause of death among people aged 15 to 29, and is the leading cause of death from car crashes.

Each year, some 1.2 million people die in crashes and some 50 million are injured, according to the World Health Organization. These rates are expected to rise 65 percent over the next
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