Early Treatment

Most patients with moderate or severe traumatic brain injury (TBI) are first admitted to the intensive care unit (ICU). From the point of view of the brain, the goals of treatment in the ICU are to minimize the risks of additional or secondary damage to the brain. In particular, physicians monitor closely to ensure that there is not too much swelling and pressure building up inside the brain (intracranial pressure). If it looks like the intracranial pressure (ICP) is too high, several treatments might be given, including medications, hyperventilating a patient or even removing part of the skull (craniectomy) to allow more room for the brain. In addition to the ICP, the staff also monitors blood pressure, oxygen levels, temperature, etc. Currently, there are no drugs routinely given to actually treat the brain damage directly. Although many drugs have been studied, none of them have been successful in reducing the amount of brain damage. Some hospitals are treating patients by cooling their body temperature (hypothermia) with the hope that this will reduce the amount of brain damage, but this treatment is still being studied.