Emergency department evaluation and management of severe traumatic brain injury

Traumatic brain injury is a significant cause of long-term disability and death worldwide. Recent advances in the acute management of traumatic brain injury have improved outcomes across the full spectrum of disease, including severe injury. Early recognition, optimization of oxygenation and perfusion, and appropriate disposition are essential components of care for patients with severe traumatic brain injury. A systematic history and physical examination are critical to identifying life-threatening injuries and guiding timely interventions, including management of elevated intracranial pressure. This review summarizes current evidence-based recommendations for the emergency department evaluation and management of severe traumatic brain injury, highlights ongoing controversies, and identifies key areas for future research.