, Volume 2, Issue 4, pp 427-429

State of the Art in Cerebral Trauma: A Neurosurgeon’s Perspective

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Commentary

Neurosurgery has always played an integral role in the management of cerebral trauma but, historically, treatments were limited and mortality and morbidity high. While cerebral trauma remains a leading cause of death worldwide, advancements in basic science injury models, pharmacology, and prevention strategies over the past several decades have resulted in a better understanding of injury mechanisms and have lead to improved outcomes in certain groups. The elucidation of the pathophysiology of secondary brain injury has lead to more targeted therapies; and the establishment of evidence-based guidelines has systematized the management of cerebral trauma, spawning the growth of neurocritical care, multimodal neuromonitoring, and the resurgence of surgical management.

Cerebral trauma consists of a heterogeneous group of primary injuries with different causes, presentations, severity, and outcomes, but the final common pathway that leads to the most deleterious effects is that of