Analytic Reviews : State-of-the-art Management of Severe Closed-head Injury

Abstract

Brain injury represents the most serious result of head trauma. In the last decade we have witnessed important advances in understanding the pathophysiological re sponses of the brain and body to severe head injury. A significant increase in good recoveries and reduction in mortality have been realized by using programs that provide rapid transport and patient triage, early diag nosis of intracranial masses and removal of large lesions, controlled positive-pressure ventilation, treatment of elevated intracranial pressure, prevention of secondary insults, and intensive management. This review empha sizes acute management of severe closed-head injury in an intensive care unit setting. Many of these same princi ples for trauma can be applied to the intensive manage ment of any brain injury, including stroke. Future ad vances are discussed.