Development of guidelines for the management of severe head injury

Organized neurosurgery has taken a major step forward in developing guidelines for the management of severe head injury. This represents the first area in which neurosurgeons have tackled this difficult but important undertaking. The head injury guidelines, which are to be published soon, are evidenced-based, i.e., they are based upon published data rather than on expert opinion. The quality of data has been carefully analyzed and graded. The level of the recommendations, i.e., standard, guideline, or option, is based upon the strength of the data available. An attempt is made to provide a summary of the terminology and methodology used to develop guidelines. Arguments for and against practice guidelines are also summarized.