Severe Traumatic Brain Injury: A Review for the General and Trauma Surgeon

Every year, 2.8 million people in the USA are affected by traumatic brain injury (TBI). Hospital admission is necessary for 285,000 patients and mortality reaches 56,000. Progress has occurred in the management of this population, on account of validated protocols such as Advanced Trauma Life Support (ATLS), yet monitoring is often restricted to neurological evaluations and conventional clinical variables. Evidence concerning immediate and late functional disabilities, along with interventions to curtail such consequences, is scarce. A more aggressive routine such as that outlined here including the use of intracranial pressure monitoring and decompressive craniectomy should be considered. It could contribute to improved short- and long-term outcomes.