[Diagnostic and therapeutic measures in craniocerebral trauma in the intensive care unit]

Diagnostic and therapeutic measures after severe head-injury in the intensive care unit are discussed. The main goal of all efforts consists in minimizing secondary brain damage. Adequate shock therapy in the initial phase proves crucial for the later outcome. Methods and indications of intracranial pressure monitoring are described. Electrophysiological tests, transcranial doppler sonography, EEG and serial CCT controls provide valuable additional information. Frequent clinical assessments however remain the golden standard despite all technical advances. Surgical and conservative modalities of therapy are further examined. Controversial methods (barbiturates, steroids, some osmotic active agents) as well as new concepts of therapy are also included. The clinician is provided with a critical discussion of the value of the different methods from our point of experience.