Summary

The objectives embedded in the management of traumatic brain injury (TBI) include limiting the primary damage and controlling secondary insults, which are thrust upon the brain immediately after an accident. Applying the recommendations of evidence-based guidelines approved by the American Association of Neurological Surgeons attains these objectives. At the scene of accident, airway support, ventilation and oxygenation are strongly recommended in trying to keep the systolic blood pressure (SBP) of the patient at around 100 mmHg [1]. Upon stabilization of the hemodynamic and pulmonary function, the victim is transferred rapidly by surface or air into the closest trauma center. In the emergency department (ED), one must maintain an SBP of at least 90 mmHg with adequate SPO2 before any other diagnostic procedure is performed, including CT of the head. When faced with multiple trauma, surgical prioritization depends on stability of vital signs, clinical evidence of herniation, findings on CT and intracranial pressure. A rapidly deteriorating patient should have infusion of mannitol and short-term hyperventilation en route to the CT suite. To prevent secondary brain insults, especially ischemia and brain swelling, the victim of TBI needs 3-4 weeks of vigilant supportive care in the intensive care unit

(ICU), including ICP control and perfusion pressure management, adequate ventilation, infection control, nutritional support, physical and occupational therapy. Physical, mental and occupational rehabilitation in a well equipped center prepares the patient for ultimate social integration.

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Free Yourself from Panic Attacks

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