Modern Treatment of Severe Head Injury

ABSTRACT

Recently advanced treatment of head injury has substantially improved result. Aggressive and intensive treatment has not only saved lives but has also reduced morbidity. This article elucidates the problems that must be dealt with in the management of severe head injury patients and develops guidelines in basic principles of modern treatment of head injury in making surgical decision. The rapid establishment of adequate ventilation and circulation is the first step. Next is followed by rapid evacuation of space-occupying mass lesions. Intensive monitoring of intracranial pressure and cerebral perfusion pressure is important. Finally deteriorating secondary injuries should be avoided. Many drugs have been claimed to be beneficial in animal studies, including lipid peroxidation inhibitors, free radical scavengers, NMDA receptor blockers, calcium channel blockers, monosialic gangliosides, and polyamine. New agents with efficacy either in lowering raised ICP or protecting the nervous system are introduced, and the results of their application are to be included.