MedStar National Rehabilitation Hospital
Faculty provides care for thousands suffering from mild to traumatic brain injuries. The concussion clinic at Medstar NRH focuses primarily on this form of brain injury and is regarded as one of the best in the country according to U.S. News & World Report. 75 percent of all traumatic brain injuries that occur are concussions. Traumatic brain injuries contribute to a third of all deaths in the United States with over 1.5 million brain injuries occurring each year. During their stay, patients are also educated on precautions they can take to prevent a future incidence.
Traumatic brain injury
Neuroimaging is helpful but not flawless in detecting raised ICP. A more accurate way to measure ICP is to place a catheter into a ventricle of the brain, which has the added benefit of allowing cerebrospinal fluid to drain, releasing pressure in the skull. Treatment of raised ICP may be as simple as tilting the person's bed and straightening the head to promote blood flow through the veins of the neck. Sedatives, analgesics and paralytic agents are often used. Hypertonic saline can improve ICP by reducing the amount of cerebral water (swelling), though it is used with caution to avoid electrolyte imbalances or heart failure. Mannitol, an osmotic diuretic, appears to be equally effective at reducing ICP. Some concerns; however, have been raised regarding some of the studies performed. Diuretics, drugs that increase urine output to reduce excessive fluid in the system, may be used to treat high intracranial pressures, but may cause hypovolemia (insufficient blood volume). Hyperventilation (larger and/or faster breaths) reduces carbon dioxide levels and causes blood vessels to constrict; this decreases blood flow to the brain and reduces ICP, but it potentially causes ischemia and is, therefore, used only in the short term. Giving corticosteroids is associated with an increased risk of death, and so their routine use is not recommended.