Encyclopedia of Intensive Care Medicine

2012 Edition
| Editors: Jean-Louis Vincent, Jesse B. Hall

Traumatic Brain Injury, Initial Management

Reference work entry
DOI: https://doi.org/10.1007/978-3-642-00418-6_863
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Synonyms

 Brain trauma;  Cerebral trauma

Definition

Traumatic brain injury (TBI) encompasses the spectrum of injury from mild closed head injury (CHI) resulting in concussions, to severe traumatic brain injury (sTBI) rendering a patient comatose. This chapter focuses entirely on non-penetrating injuries. The categories of TBI are divided by total Glasgow Coma Score (GCS) into mild (13–15), moderate (9–12), and severe (3–8) (Table 1). The use of the GCS allows for rapid, if somewhat blunt, communication about injury severity in the setting of TBI. It is important to recognize that the categories of injury delineated by GCS may include a variety of injury patterns, in isolation or in combination, the management of which can vary greatly. In the past, all patients with an injury in a given GCS category were included in generalized guidelines and outcomes research; however, the heterogeneity of the disease process has been recognized to influence management decisions and outcomes, and a...
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References

  1. 1.
    Finkelstein E, Corso P, Miller T (2006) The Incidence and economic burden of injuries in the United States. Oxford Press, New YorkCrossRefGoogle Scholar
  2. 2.
    Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons (2007) Guidelines for the management of severe traumatic brain injury. J Neurotrauma 24 (Suppl 1):S1–S106Google Scholar
  3. 3.
    Narotam PK, Morrison JF, Nathoo N (2009) Brain tissue oxygen monitoring in traumatic brain injury and major trauma: outcome analysis of a brain tissue oxygen-directed therapy. J Neurosurg 111(4):672–682PubMedCrossRefGoogle Scholar
  4. 4.
    Edwards P, Arango M, Balica L et al (2005) Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet 365(9475):1957–1959PubMedCrossRefGoogle Scholar
  5. 5.
    Chamoun RB, Robertson CS, Gopinath SP (2009) Outcome in patients with blunt head trauma and a Glasgow Coma Scale score of 3 at presentation. J Neurosurg 111(4):683–687PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Departments of Emergency Medicine and NeurosurgeryUniversity of CincinnatiCincinnatiUSA