Severe traumatic brain injury: acute treatment based on cerebral perfusion pressure

Abstract

Severe traumatic brain injury is a cause of disability with economic and social repercussions. Prehospital care is a fundamental part with important attention to avoid hypoxemia, hyperventilation, and hypotension with airway protection. During the primary evaluation, a clinical examination is performed focused on classifying according to their severity, neurological involvement, and extracranial lesions and providing a prognosis. Invasive or non-invasive intracranial pressure monitoring aims to direct management to maintain adequate cerebral perfusion pressure, which should be individualized in each patient, as this depends on the status of self-regulation.