The 2013 neurosurgery guidelines mention two of the more controversial therapies used in spinal cord injuries:
- “MAP Push” (maintaining the patient’s MAP 85-90mmHg, which theoretically increases the blood flow to the penumbra): evidence for the particular MAP goal is not great, but studies show that ICU level monitoring for the first 7-14 days improves outcome as patients may have delayed cardiovascular or pulmonary instability
- Steroids are not recommended anymore (they were an “option” in the previous guidelines)
References
Neurosurgery. 2013 Mar;72. Updated Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injury. Resnick DK
