Neurotrauma is a head or spine injury caused by a sudden injury. It includes concussions, traumatic brain injuries (TBI), skull fractures, spinal column fractures, and spinal cord injuries (SCI). The Neurotrauma Program of the Mount Sinai Health System, Department of Neurosurgery has neurosurgeons whom are specifically trained and equipped to diagnose and treat all types of neurotrauma.

Head Trauma

Head trauma is any injury to your head, from a minor bump on the skull to serious brain trauma. It usually comes from getting hit on the head or skull and can happen if you fall, if there’s a sudden acceleration-deceleration (as in a motor vehicle accident or child abuse) or assault, or if you’re hit by a projectile like a bullet. Head trauma can cause your brain cells to malfunction. The extent of the injury and how long it lasts depends on how badly you were hurt.

We treat the following types of head trauma :

  • Concussion
  • Mild TBI
  • Moderate TBI
  • Severe TBI (typically involves a coma)
  • Penetrating brain injury (such as gunshot, stab wound)
  • Depressed skull fracture
  • Craniofacial trauma
  • Epidural hematoma
  • Acute subdural hematoma
  • Subacute and chronic subdural hematoma
  • Traumatic subarachnoid hemorrhage
  • Traumatic intracerebral hemorrhage/brain contusion
  • Traumatic cerebrospinal fluid leak
  • Traumatic pseudoaneurysm
  • Blunt cerebrovascular injury

Spine Trauma

You can also have an injury to your spinal column (cervical, thoracic, or lumbosacral spine) or spinal cord due to a fall, car accident, collisions with a moving object (such as a car), or an assault. As with head injuries, there are many types of spine trauma, which vary in severity. Depending on what happened, you might become weak or paralyzed. We routinely treat these types of spine trauma :
  • Spinal cord injury
  • Craniocervical spine injury
  • Cervical spine injury
  • Thoracic spine injury
  • Lumbosacral spine injury
  • Atlanto-occipital dissociation
  • Jefferson (C1) fracture
  • Hangman’s (C2) fracture
  • Odontoid (dens) fracture
  • Traumatic central cord syndrome
  • Perched/jumped facets
  • Compression (anterior wedge) fracture
  • Burst fracture
  • Chance fracture
  • Fracture-dislocation
  • Traumatic pars defect (spondylolysis)
  • Traumatic spondylolisthesis
  • Traumatic intervertebral disc herniation
  • Complex sacropelvic injury
  • Hyperflexion injury
  • Hyperextension injury
  • Compression injury
  • Distraction injury
  • Spinal ligamentous injury

Diagnosis

Neurotrauma can occur by itself, or together with other bodily injury. Most people who experience serious injury to their head or spine come to the hospital through the emergency room (ER) and do not schedule appointments or pick their surgeons. When you come to our ER, we immediately evaluate you for head or spine injury, often utilizing a brain scan to give us a clear view of your injuries. Typically, we use a computed tomography (called CT or CAT) scan of the head or spine or we may use magnetic resonance imaging (MRI) instead.
If after you leave the hospital, you have problems with social situations or easy tasks, you should immediately return to Mount Sinai for further examination.
Imaging scans are not always enough to know exactly what is happening in your brain or spine. To diagnose a TBI, we conduct :
  • Detailed neurological examinations, which may include a scoring system called the Glasgow Coma Scale. This scale helps us assess the severity of a brain injury by checking your ability to follow directions, blink your eyes, and move your arms and legs. We also take into account whether you’re speaking coherently. Every brain injury is different, but in general, high scores mean milder injuries.
  • Cognitive evaluations by a neuropsychologist with formal neuropsychological testing
  • Evaluations by physical and occupational therapists

Neurotrauma Treatment

The way we treat head and spine injuries depends on several factors, including the type of injury and how serious it is. Mild injuries may just require careful observation. More severe trauma may call for surgery. Certain types of injuries need surgery, even if they are not very severe.
At Mount Sinai, we also offer neuropsychological therapy, speech therapy, physical therapy, occupational therapy, and rehabilitation medicine, depending on your needs.
We perform the following surgical procedures :
  • External ventricular drain placement
  • Intracranial pressure monitoring
  • Intracranial multimodality monitoring
  • Lumbar drain placement
  • Bedside subdural evacuating port system placement
  • Burrhole for subacute/chronic subdural hematoma
  • Craniotomy for evacuation of hematoma
  • Decompressive craniectomy
  • Cranioplasty
  • Elevation of depressed skull fracture
  • Cranialization of the frontal sinus
  • Complex craniofacial repair
  • Traumatic cerebral spinal fluid leak repair
  • External bracing for spine injury
  • Halo stabilization
  • Closed reduction/traction for spine fracture
  • Open reduction/treatment for spine fracture
  • Spinal decompression
  • Instrumented spine stabilization
  • Minimally invasive spine instrumentation
  • Spinal fusion
  • Sacropelvic spine instrumentation and fusion
  • Kyphoplasty/vertebroplasty
Most people with mild traumatic injuries to the head or spine end up doing well and many recover completely. Sometimes, though, even after a mild injury like a concussion, you may have symptoms that don’t go away. If this happens, we will help you. Consult Dr Vivek Agrawal.
Achievements
Dr. Vivek M. Agrawal has been associated with VIMS HOSPITAL as chief consultant Neurosurgeon/ Spine surgeon since its beginning. Till JULY 2022, he has performed more that 700 Brain and spine surgeries and seen more than 5500 OPD patients. He has been doing regular CMEs and free Camps for the patients benefit.
He is doing all kinds of brain and spine related surgeries including complex vascular surgeries, endoscopic surgeries, minimally invasive spine surgeries