Severe brain injury management

Management of severe brain injury, the main cause of death in young population, has now standardized principles that lead to the improving of the outcome. The treatment of this traumatic illness is directly connected to cerebral physiopathology. After the impact, there are some cerebral mechanisms that are modified and are responsible for the appearance of the secondary injury: damaging of the cerebral metabolism, which has characteristic a very high metabolic rate compared to other tissues, altering the cerebral blood flow responsible for the cerebral oxygenation, altering the blood brain barrier with direct consequences on cerebral edema. Therefore, therapeutic aspects are connected to monitoring and will address to ensuring the hemodynamic stability, accurate oxygenation and correction of the factors that may worsen secondary injury (temperature, glycemia, osmolarity).