Typical symptoms of TBI represent headache, nausea and vomiting, dizziness, blurred vision, paresis, aphasia, seizures and impaired coordination on the physical side. Cognitive impairments include attention, memory and concentration disorders or decreased processing speed whereas behavioural symptoms present as depression, anxiety, agitation or aggression. Persistence of these symptoms results in a vicious cycle of impaired skill acquisition and an adaptive deficit with increased academic failure, unemployment and loss of salary, social and behavioural dysfunction and isolation.
The injury severity of TBI is commonly classified according to the established Glasgow Coma Scale (GCS) and the TCDB classification in CT-Scans.
Established non-surgical treatment of intracranial pressure after TBI emphasizes on hyperventilation, hypothermia as well as application of mannitol, hypertonic saline solution or barbiturates. Recently, neuroprotective effects of erythropoietin (EPO) have been demonstrated. Surgical therapy consists of lumbar drainage of cerebrospinal fluid, decompressive craniotomy, and the evacuation of mass lesions.
While scientific data concerning the classification of TBI, treatment and outcome prediction has significantly progressed over the last two decades identifying risk factors and treatment options, further research is needed consolidating first-, second- and third-tier treatment. Identifying treatment pathways based upon potential predictive factors and rehabilitative outcome is thought to improve family support of patients concerned and to optimize health care requirements.
Florian Urbanek: Current Opinions on Epidemiology, Treatment and Outcome After Traumatic Brain Injury
Last date updated on November, 2020