Traumatic brain injury (TBI): management

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Traumatic brain injury (TBI): management. Glasgow coma scale (GCS) score <15, Seizure, Focal neurology. Fully referenced neurology checklist.

Indications for hospital referral

  • Glasgow coma scale (GCS) score <15
  • Seizure
  • Focal neurology
  • Skull fracture
  • Loss of consciousness
  • Severe persistent headache
  • Repeated vomiting
  • Retrograde amnesia >30 minutes
  • Road traffic accident (RTA)
  • Significant fall
  • Coagulopathy

Hospital management

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Management of raised intracranial pressure (ICP)

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Potential treatments of disorders of consciousness after TBI

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Prophylactic anti-epileptic dugs (AEDs)

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Emerging treatments

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Synonym

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References

  1. Scottish Intercollegiate Guidelines Network. Early management of patients with a head injury: a national clinical guideline. May 2009.
  2. Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L. Clinical practice guidelines for mild traumatic brain injury and persistent symptoms. Can Fam Physician 2012; 58:257-267.
  3. Whitfield P. The management of patients with head injury. ACNR 2004; 4:14-17.
  4. Robba C, Graziano F, Rebora P, et al. Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study. Lancet Neurol 2021; 20:548-558.
  5. Mangat HS, Wu X, Gerber LM, et al. Hypertonic saline is superior to mannitol for the combined effect on intracranial pressure and cerebral perfusion pressure burdens in patients with severe traumatic brain injury. Neurosurgery 2019; pii: nyz046 (Epub ahead of print).
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