Complications and neurosurgical interventions during early rehabilitation in head injured patients

Guidelines for the treatment of traumatic brain injury (TBI) are subject of actual efforts in neurosurgery, anaesthesiology and traumatology as well as in the basic sciences. International collaborations such as European Brain Injury Consortium (EBIC), Pan-European-Advisory Board (PAB) and Euroacademy of Multidisciplinary Neurotraumatology (EMN) are working on pathophysiological understanding and evaluation of clinical outcomes to establish standards for a holistic concept from resuscitation to rehabilitation. We reviewed the courses of 252 brain injured patients, treated over a four year period in our department including surgery, intensive care and early rehabilitation. Our special interest was focussed on complications during the early rehabilitation period and the neurological outcomes to define quantity and quality of monitoring as well as the need for invasive interventions at the interface between acute and rehabilitative medicine.