Acute Central Nervous System Trauma in the Field

Acute central nervous system (CNS) trauma in the field is best approached by a systematic and thorough physical and neurologic examination that allows the practitioner to localize the brain or spinal cord injury. The skull and vertebral canal are complex 3-dimensional structures, and orthogonal radiographic views are necessary for an accurate diagnosis. Therapeutics aimed at decreasing pain, inflammation, and edema or increased intracranial pressure in the case of traumatic brain injury should be administered. Survival and return to athleticism can be achieved even in moderate-to-severe traumatic CNS injury with appropriate medical management.