Trauma Care

Neurologic trauma continues to be a major public health problem, even with modern trauma care in the 21st century. Appropriate management of a traumatic brain or spinal injury requires knowledge of the pathophysiology involved.

Traumatic Brain Injury

The brain has several features that distinguish it from other organ systems. The most important of these differences is that the brain is contained within the skull, a rigid and inelastic container. Because of this, only small increases in volume within the intracranial compartment can be tolerated before pressure within the compartment rises dramatically, causing neurological sequelae. This concept is known as the Monro-Kellie doctrine, which states that the total intracranial volume is fixed by the inelastic volume of the skull. This volume is divided into three compartments: the brain parenchyma, the blood volume, and the cerebrospinal fluid (CSF). When a significant head injury occurs, cerebral edema often develops, which increases swelling in the brain. Because the space inside the skull is fixed, the pressure within this compartment rises unless some action occurs to decrease in the volume of one of the other intracranial components.

Traumatic Spine and Spinal Cord Injury

The diagnosis of an unstable spinal injury and its subsequent management can be difficult, and a missed spine injury can have devastating long-term consequences. Therefore, spinal column injury must be presumed until it is excluded. The main concerns are which patients can be cleared by clinical exam alone, which imaging studies are necessary, and when should additional imaging be used. An assessment for ligamentous injury in the absence of a fracture is also important, especially in unconscious patients who are unable to complain of neck pain or tenderness.

Meet our Pediatric Neurosurgery Physicians

Dr. Veetai Li

MD

Dr. Veetai Li areas of expertise are: pediatric neurosurgery, including congenital neurosurgical conditions; brain tumors; surgical…

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MD

Dr. Renée Reynolds

MD FAANS

Dr. Reynolds’ areas of expertise are: pediatric neurosurgery, including congenital neurosurgical conditions; brain tumors; surgical management…

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MD FAANS

Pediatric Neurosurgery Locations

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  • Gates Vascular Institute

  • Oishei Children’s Hospital and Outpatient Center

  • Comprehensive Neuroscience Center

Surgical Locations:  Sisters of Charity Hospital, Niagara Falls Memorial Medical Center, Millard Fillmore Suburban Hospital, Mercy Hospital of Buffalo, Buffalo General Medical Center, Gates Vascular Institute, Kenmore Mercy Hospital

Please notify our office immediately if you have a fever, cough, runny nose, or shortness of breath or have been in contact with someone who has been diagnosed with COVID-19. UBNS is following all CDC and New York State Dept. of Health guidelines for preventing the spread of COVID-19.