Traumatic Brain Injury: Evidence-Based Medicine, Diagnosis, and Treatment

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. The initial trauma triggers a complex cascade of cellular and tissue changes with subsequent secondary injury of the vulnerable brain. Injury can result from derangements of multiple physiological parameters including blood pressure, intracranial pressure, oxygenation, and temperature. The monitoring and treatment of the multiple physiological derangements that can result after TBI are an important aspect of the intensive care management of this patient population, but the specific treatment thresholds for each variable and their relationship to outcome are varied. The focus of this chapter is on severe traumatic brain injury and its treatment with an emphasis on the recommendations from the guidelines of the Brain Trauma Foundation