[Diagnosis and treatment of traumatic brain injury].
Traumatic brain injury (TBI) is still the major cause of death under 45 years of age and an important one for children under 15. Its incidence is 332/100,000 inhabitants. It results from an impact with the skull with/without lesion of the brain but at least a short-term neurological disorder. All other injuries to the skull should be called concussion. The duration of unconsciousness defines the severity of TBI. Patients with TBI should be admitted to a surgical ward. Those retaining consciousness and with GCS scores of 15 might be allowed to go home if under surveillance. With GCS of <15 or with risk factors, TBI requires a CT scan and in-hospital surveillance. Acutely life-threatening, i.e. space-occupying, bleeding must be operated on immediately. Epidural or subdural bleeding, especially in comatose patients, is still a vital risk and thus requires immediate surgery.
Rickels
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Bereich Neurochirurgie, AKH Celle, Siemensplatz 1, Celle, Germany. eckhard.rickels@akh-celle.de
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001929:Brain Edema / Q000175:diagnosis / Q000601:surgery; D001930:Brain Injuries / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D003422:Critical Care / Q000379:methods; D015600:Glasgow Coma Scale; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000601:surgery; D046648:Hematoma, Subdural, Intracranial / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007223:Infant; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000601:surgery; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010343:Patient Admission; D010348:Patient Care Team; D012887:Skull Fractures / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014207:Trephining; D055815:Young Adult