Management of Head Injury

Guideline-Based Management

The American College of Radiology recommends acute imaging with CT scan to detect neurosurgical lesions, such as hemorrhage, herniation, and hydrocephalus, in patients with head injury 1, 2
The Anaesthesia society recommends hemodynamic stabilization, maintaining systolic blood pressure >110 mmHg, in patients with head injury 2, 3
The Anaesthesia society also recommends airway control and ventilation management with end-tidal CO2 monitoring in patients with head injury 2, 4, 5
The Anaesthesia society suggests intracranial pressure monitoring and management through sedation, CSF drainage, or decompressive craniectomy when indicated in patients with head injury 4, 5
The Anaesthesia society recommends neurosurgical intervention for symptomatic hematomas, hydrocephalus, or mass effect in patients with head injury 4, 5

The Anaesthesia society recommends preventing hypotension, as even single episodes can worsen outcomes in patients with head injury 2, 3
The Anaesthesia society suggests avoiding hypocapnia, as prolonged hyperventilation can worsen ischemic injury in patients with head injury 6
The American College of Radiology recommends early CT imaging for appropriate patients based on clinical decision rules 1
The Anaesthesia society recommends timely neurosurgical intervention when indicated in patients with head injury 4, 5
The Anaesthesia society suggests avoiding 4% albumin, as it is associated with increased mortality in severe TBI 6