Trauma

This chapter presents the background, prevention, diagnosis, treatment, special populations, prognosis, reading list, guidelines, evidence for therapies and images for traumatic brain injury (TBI). Injuries are divided into two categories: primary and secondary. Primary injury occurs at the time of the trauma; secondary injury occurs as an adverse result of the physiologic response after the initial impact. Diagnosis relies on correlating detailed neurologic findings with the mechanism of injury, and this can be supplemented by radiologic findings. Treatment for TBI is largely supportive; however, surgery is necessary when mass lesions, hydrocephalus, or edema cause significant displacement or compression of brain tissue. Treatment for spinal cord injury (SCI) depends on the extent and mechanism of injury. The goals of treatment are stabilization of structural damage and relief of nervous system compression.