Mark Wilson

Bio

Mark Wilson is a Neurosurgeon and Pre-Hospital Care Doctor in London. He specialises and researches into neurotrauma, hypoxia (especially high altitude) and intracranial pressure issues. He has worked extensively overseas and on a number of expeditions. He set up the Neurotrauma unit at Imperial and co-founded GoodSAM (www.goodsamapp.org) which alerts those trained to nearby life threatening emergencies.


Neurocritical Care Improves Outcomes in TBI Patients

This debate will demonstrate that apart from maintaining an airway, critical care is of no benefit to neurotrauma patients.
The New England Journal of Medicine has published a number of articles recently that demonstrate no benefit from classic neurotrauma interventions (ICP monitoring, cooling, decompression). This is because factors such as ICP and CPP are associated with bad outcome by association rather than causation. This debate will demonstrate that critical care just complicates things and it is high time for the randomised trial between the very best Neurocritical care and NOB therapy (Naso-pharyngeal, Oxygen and a Blanket).

Unsexy Neurotrauma

Traumatic brain injury (TBI) is a disease of the elderly, on warfarin who fall from standing ! Decision making is as/more important than surgery. This an other unsexy aspects will be discussed!

Neurotrauma has classically been a disease of young men who come off motorbikes – treatment involves helicopters, on-scene RSI and surgery by god-like neurosurgeons. This, however, is no more. Neurotrauma is now a disease of the elderly on warfarin (and other poisons) who require a couple of burr holes 7 days after the clopidogril has worn off. This change in demographic genuinely requires a shift to a considerably more holistic approach. Family involvement and good decision making is more important than cerebral perfusion pressure. Novel anticoagulants may well hamper options. Other aspects of neurotrauma also sadly lack helicopter involvement – ventriculitis, venous thrombosis, syndrome of the trephined … These and other conditions will be sex’d up in this dossier of Unsexy Neurotrauma.


Neurotrauma has classically been a disease of young men who come off motorbikes – treatment involves helicopters, on-scene RSI and surgery by god-like neurosurgeons. This, however, is no more. Neurotrauma is now a disease of the elderly on warfarin (and other poisons) who require a couple of burr holes 7 days after the clopidogril has worn off. This change in demographic genuinely requires a shift to a considerably more holistic approach. Family involvement and good decision making is more important than cerebral perfusion pressure. Novel anticoagulants may well hamper options. Other aspects of neurotrauma also sadly lack helicopter involvement – ventriculitis, venous thrombosis, syndrome of the trephined … These and other conditions will be sex’d up in this dossier of Unsexy Neurotrauma.



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