Pen Is Mightier than the Sword: Columbia Shows the Way in Formulating Neurotrauma Guidelines

摘要

The saying “one shoe does not fit all” is especially true for traumatic brain injuries (TBI) which occurmost frequently in resource constrained low- and middle-income countries (LMICs), yet manage patientsbased on guidelines emanating from high-income countries (HICs). A prime example is intracranialpressure (ICP) monitoring. In countries like India where majority of the population is uninsured or poorlyinsured, more than 90% of all severe TBI’s are managed without ICP monitoring, simply because the costof ICP catheter is prohibitive to most neurosurgical centres. Despite practical issues like this, thenational societies of these countries continue to rubber stamp the brain trauma foundation guidelines,without looking at the ground realities in the country.