• Chirurg · Feb 2009

    [Diagnosis and treatment of traumatic brain injury].

    • E Rickels.
    • Bereich Neurochirurgie, AKH Celle, Siemensplatz 1, Celle, Germany. eckhard.rickels@akh-celle.de
    • Chirurg. 2009 Feb 1;80(2):153-62; quiz 163.

    AbstractTraumatic brain injury (TBI) is still the major cause of death under 45 years of age and an important one for children under 15. Its incidence is 332/100,000 inhabitants. It results from an impact with the skull with/without lesion of the brain but at least a short-term neurological disorder. All other injuries to the skull should be called concussion. The duration of unconsciousness defines the severity of TBI. Patients with TBI should be admitted to a surgical ward. Those retaining consciousness and with GCS scores of 15 might be allowed to go home if under surveillance. With GCS of <15 or with risk factors, TBI requires a CT scan and in-hospital surveillance. Acutely life-threatening, i.e. space-occupying, bleeding must be operated on immediately. Epidural or subdural bleeding, especially in comatose patients, is still a vital risk and thus requires immediate surgery.

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