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48 - Severe Traumatic Brain Injury
from Section 11 - Trauma
- By Jacob D. Isserman
Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
Book:

Practical Emergency Resuscitation and Critical Care

Published online:

02 November 2023

Print publication:

23 November 2023, pp 516-527
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Summary

Severe traumatic brain injury (TBI) is usually defined as a Glasgow Coma Scale (GCS) score < 9. The goals of early resuscitation should focus on identifying and treating the primary injuries and limiting the negative cascade of secondary injuries such as hypotension and hypoxia. All patients with suspected severe TBI need an emergent computed tomography (CT) scan of the brain to identify hemorrhage immediately following initial stabilization. Ten percent of severe TBI patients have concomitant c-spine injury.