THE LUND CONCEPT OF POSTTRAUMATIC BRAIN EDEMA THERAPY

A new therapy of post-traumatic brain oedema has recently been introduced into clinical practice at the University Hospital of Lund, Sweden (1). This therapy is based on basal physiological principles, presuming that an important part of post-traumatic brain swelling is due to extracellular oedema, in turn caused by disturbance of the normal volume regulation of the brain. Thus, the aim of therapy is to prevent brain herniation by keeping intracranial pressure (ICP) at a safe level until the normal volume regulating mechanisms of the brain, namely the semi-permeable blood-brain barrier (BBB) and cerebrovascular autoregulation, have been restored. Tn clinical practice, this concept has dramatically improved outcome in severely head injured patients, when compared to historical control groups.