Citation

Godoy DA, Rovegno M, Carrizosa J. Neurosurgery 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, Congress of Neurological Surgeons)

DOI

10.1227/neu.0000000000003087

PMID

38949301

Abstract

In response to Chaurasia et al,1 we are writing to express our appreciation for your insightful letter discussing the Latin American Brain Injury Consortium (LABIC) consensus on moderate traumatic brain injury (moTBI) in adults.1 Your emphasis on the importance of precise definitions, adequate categorization, and individualized approaches in diagnosing moTBI is crucial for improving patient outcomes and guiding treatment strategies.1 In addition, the recognition of how socioeconomic factors can affect the incidence, management, and outcomes of moTBI is essential for developing holistic and effective interventions.1 Your call for increased public awareness, education, and preventive measures is a crucial step toward mitigating the effect of moTBI on individuals and society as a whole.1 We also agree with Chaurasia et al1 that our LABIC consensus is an effort for a better understanding and approach to different aspects and gaps in this entity.2 It only represents a starting point to develop new studies in moTBI, to move from expert opinion to recommendations based on medical evidence. It is important to clarify that this consensus is not a rigid list of recommendations or suggestions, but rather, it must be adapted to the local reality and resources of each center. In addition, we agree with the sentence that "One of the notable features of the LABIC consensus is its recognition of the variety of clinical manifestations and prognoses connected to moTBI."1 Because moTBI may erroneously carry the false precept of being a nonserious condition around the name itself,3 we highlight the categorization of this group of patients with TBI and the proposed definition of neurological worsening obtained in the consensus to be aware of the risks of complications. Finally, as we mentioned after consensus, we are looking for trials with the "moderate" label for TBI. In this line, the study NCT04900168 is an observational trial aimed at determining whether monitoring intracranial pressure (ICP) in patients with moderate TBI improves medical practice and outcomes of patients in China.4

Furthermore, NCT05855252 is an epidemiological study to study the variability of treatment in moderate and severe TBI in different hospitals across Australia.5

In conclusion, your letter serves as a poignant reminder of the challenges and opportunities in the field of moTBI management. By advocating for precise definitions, individualized approaches, and a comprehensive diagnostic process that integrates neuroimaging and clinical findings, you have underscored the importance of personalized and evidence-based care for individuals with moTBI. ...

Language: en