Journal of Emergencies, Trauma, and Shock
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EDITORIAL  
Year : 2019  |  Volume : 12  |  Issue : 3  |  Page : 167
Whats new in emergencies, trauma and shock? Traumatic subarachnoid hemorrhages versus traumatic nonsubarachnoid intracranial hemorrhages


Department of Neurosurgery, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India

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Date of Submission01-Feb-2019
Date of Acceptance03-Feb-2019
Date of Web Publication27-Aug-2019
 

How to cite this article:
Agrawal A. Whats new in emergencies, trauma and shock? Traumatic subarachnoid hemorrhages versus traumatic nonsubarachnoid intracranial hemorrhages. J Emerg Trauma Shock 2019;12:167

How to cite this URL:
Agrawal A. Whats new in emergencies, trauma and shock? Traumatic subarachnoid hemorrhages versus traumatic nonsubarachnoid intracranial hemorrhages. J Emerg Trauma Shock [serial online] 2019 [cited 2019 Nov 20];12:167. Available from: http://www.onlinejets.org/text.asp?2019/12/3/167/265383




In the present study, the authors analyze data of 12,482 patients who presented with the history of trauma and included all awake cases (Glasgow Coma Scale 13–15) who had either traumatic subarachnoid hemorrhage (SAH) (n = 225) and non-SAH-intracranial hemorrhage (ICH) (n = 826).[1] The authors made interesting observations that patients with isolated traumatic SAH with preserved consciousness have a significant survival advantage over the patients who had other types of ICHs (i.e., subdural).[1] The present study further highlights that traumatic SAH primarily needs conservative management and other types of traumatic ICHs need frequent neurosurgical intervention, i.e., evacuation of the hematomas.[1] The authors further provide preliminary evidence that care of isolated traumatic SAH patients with preserved levels of consciousness is less resource intensive; however, this needs to be confirmed in further larger studies.[1]

The authors very well highlight the limitations of the present study (lack of long-term follow-up and functional outcome), and this area needs further investigations, i.e., a larger prospective multicenter study. In addition, while planning the future studies, we need to include the complications associated with traumatic SAH which include hydrocephalus, vasospasm, dyselectrolytemia, and pituitary and/or hypothalamic dysfunction as all these can affect the outcome.[2],[3]



 
   References Top

1.
Diaz B, Elkbuli A, Wobig R, McKenney K, Jaguan D, Boneva D, et al. Subarachnoid versus nonsubarachnoid traumatic brain injuries: The impact of decision-making on patient safety. J Emerg Trauma Shock 2019;12:[Current Issue].  Back to cited text no. 1
  [Full text]  
2.
Kakarieka A. Review on traumatic subarachnoid hemorrhage. Neurol Res 1997;19:230-2.  Back to cited text no. 2
    
3.
Modi NJ, Agrawal M, Sinha VD. Post-traumatic subarachnoid hemorrhage: A review. Neurol India 2016;64 Suppl S1:8-13.  Back to cited text no. 3
    

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Correspondence Address:
Amit Agrawal
Department of Neurosurgery, Narayana Medical College Hospital, Nellore, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JETS.JETS_20_19

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