[Traumatic brain injury--pathophysiology and clinic seen from a neurosurgical point of view]

Traumatic brain injury (TBI) can be divided into primary and secondary brain damage. The primary damage occurs at the time of impact, induces neuronal death and is refractory to treatment. The secondary damage occurs at some time after the impact, has extracranial (hypoxia/hypotension) and intracranial (haematomas/swelling) causes and is largely preventable and treatable. Initially, TBI should be treated by the principles of ATLS. Space-occupying haematomas should be evacuated and neuro-intensive monitoring and treatment of intracranial pathology are mandatory in severe TBI.