Effectively Diagnosing and Treating Traumatic Brain Injuries with Dr. Halinder Mangat Brain Trauma Foundation TRANSCRIPT

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12d ago

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Dr. Halinder Mangat, Director of Research at the Brain Trauma Foundation, has developed evidence-based guidelines for treating severe traumatic brain injuries, which have been shown to improve outcomes significantly. The Foundation is conducting research in collaboration with the US Defense Department and Veterans Administration, including a clinical trial on the use of lumbar drainage to reduce intracranial pressure from a brain injury. While the brain was once thought incapable of healing, research shows early intervention from injuries can result in the regeneration of cells and formation of new neural circuits.

Halinder explains, "The initial focus of the Brain Trauma Foundation's mission was treatment. The Brain Trauma Foundation in 1997 became the first surgical organization and first professional body to produce evidence-based guidelines for the treatment of severe head injury. That means looking at the comprehensive literature body, finding out what robust research is, and compiling it all. Some studies may have contradictory results. We compile it all in a very objective, systematic way to then frame recommendations as to the best practice, and these fall under the umbrella of evidence-based medicine. In 1997, the first edition was published. Over the years, multiple studies have shown that this set of guidelines has improved good outcomes or decreased poor outcomes by 50%, which is the most remarkable intervention, perhaps short of vaccines or antibiotics. But in the surgical field, it is probably the most impactful intervention."

"So the first impact of the injury causes X amount of damage, and then following that, there is a cascade of it like dominoes falling. The whole focus has been to prevent downstream dominoes from falling by early intervention. And after the first injury when a few dominoes, for example, have fallen, the goal of the guidelines has been to as early and as intensively as possible to minimize downstream dominos falling, which means secondary injury, which in itself has its own legacy of influencing outcome. Over a period of time, there's been a lot of trials to try neuroprotective drugs, which would, in the first instance, mitigate the secondary injury."

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