This literature review examined the moral and interdisciplinary clinical difficulties encountered by trauma surgeons in treating patients with penetrating brain injury (PBI) and multi-cavitary trauma. Recent findings show that resuscitation and prognostic aspects for such patients remain inadequately characterized, and trauma recommendations are outdated, but there is a large void in the literature on addressing PBI in patients presenting with multisystem trauma.
Researchers analyzed the most up-to-date evidence-based multidisciplinary recommendations for PBI and the advice of specialists in trauma, neurosurgery, neurocritical care, pediatric and transplant surgery, surgical ethics, and, most significantly, our local community. According to the findings, a multidisciplinary team approach is recommended on a case-by-case basis for PBI rather than the standard prognostic indicators used for TBI. In addition, supportive neurocritical care and neuro intervention may be necessary for addition to multi-cavitary operational intervention even if neurosurgical surgery is unnecessary.
The treatment of PBI in children requires special attention. Giving the patient the best chance of survival is paramount ethically. Organ donation is an option that should be discussed with the patient, their proxy, and their family as part of a comprehensive care plan. Institutional decision-making and the design of protocols greatly benefit from community input. Patient care following multi cavitary PBI is difficult and calls for a team approach that includes family and friends.
