Management of Moderate and Severe TBI

  • Geoffrey LingEmail author
  • Scott A. MarshallJr
  • Randy S. Bell
  • Rocco A. Armonda


The management of moderate and severe traumatic brain injury (TBI) is a complex and evolving practice in the acute neurosciences. The management, beginning in the prehospital environment to tertiary definitive medical and surgical management of TBI, is discussed. Clinical syndromes and radiographic examples of brain injury are presented, along with a current review of the literature in the early critical care phase of moderate and severe TBI management. We discuss an algorithm for managing the challenging patient and discuss areas of needed future research.


Traumatic brain injury Osmotic therapy Intracerebral hypertension Decompressive craniectomy Brain code Herniation syndromes Therapeutic hypothermia Pharmacologic coma 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Geoffrey Ling
    • 1
    Email author
  • Scott A. MarshallJr
    • 2
  • Randy S. Bell
    • 3
  • Rocco A. Armonda
    • 4
  1. 1.Department of NeurologyThe Johns Hopkins UniversityBaltimoreUSA
  2. 2.Critical Care Medicine and Vascular Neurology, Department of NeurologyIntermountain Medical CenterMurrayUSA
  3. 3.Department of SurgeryWalter Reed National Military Medical Center, Uniformed Services University of Health SciencesBethesdaUSA
  4. 4.Department of NeurosurgeryMedStar Washington Hospital Center/Georgetown University HospitalWashington, DCUSA

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