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

Autor:	Li LM; Imperial College London, London, UK and UK DRI Care Research & Technology Centre, London, UK., Dilley MD; Atkinson Morley Regional Neuroscience Centre, London, UK and Royal College of Psychiatrists, London, UK., Carson A; Centre for Clinical Brain Sciences, Edinburgh, UK., Twelftree J; Homerton University Hospital NHS Foundation Trust, London, UK., Hutchinson PJ; University of Cambridge, Cambridge, UK and Royal College of Surgeons, London, UK., Belli A; National Institute for Health Research Surgical Reconstruction Research Centre, Birmingham, UK and Institute of Inflammation and Ageing, Birmingham, UK., Betteridge S; St George's University Hospitals NHS Foundation Trust, London, UK., Cooper PN; Manchester Centre for Clinical Neurosciences, Manchester, UK., Griffin CM; St George's University Hospitals NHS Foundation Trust, London, UK., Jenkins PO; Epsom and St Helier University Hospitals NHS Trust, London, UK, St George's University Hospitals NHS Foundation Trust, London, UK and Imperial College London, London, UK., Liu C; Homerton Hospital, London, UK and Barts Health NHS Trust, London, UK., Sharp DJ; Imperial College London, London, UK and UK DRI Care Research & Technology Centre, London, UK., Sylvester R; National Hospital for Neurology and Neurosurgery, London, UK., Wilson MH; Imperial College Healthcare NHS Trust, London, UK and Imperial College London, London, UK., Turner MS; Homerton University Hospital NHS Foundation Trust, London, UK., Greenwood R; National Hospital for Neurology and Neurosurgery, London, UK and Homerton University Hospital NHS Foundation Trust, London, UK richard.greenwood2@nhs.net.
Jazyk:	angličtina
Zdroj:	Clinical medicine (London, England) [Clin Med (Lond)] 2021 Mar; Vol. 21 (2), pp. e198-e205.
DOI:	10.7861/clinmed.2020-0336
Abstrakt:	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. (© Royal College of Physicians 2021. All rights reserved.)
Databáze:	MEDLINE
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