Neurotrauma: Management of Acute Head Injuries

Christopher J. Lettieri, MD, MAJ, MC, USA


Medscape Critical Care. 2006;7(2) 

In This Article


Regardless of improved preventive measures, neurologic trauma, specifically head injuries, remains a common and often devastating occurrence. Each year, 1 million Americans (200-400 per 100,000) seek medical attention for acute head injuries, 27% of which are moderate or severe.[1,2,3,4,5] Head trauma results in approximately 70,000 deaths, 80,000 long-term disabilities, and 60,000 new seizure disorders each year.[1,2,3,4,5] These injuries most often occur in individuals who are 15-24 years old and are twice as common in men.[2,3] Causality is bimodal with vehicular accidents being most common in those under 25 years and falls in those over 75 years.[1,2,5] Nearly half involve intoxication with drugs or alcohol.[5,6]

Head injuries represent 2% to 3% of all-cause deaths and 26% to 68% of trauma-related deaths.[1,2,3,4,5,7] Mortality following severe head injuries may be as high as 30% to 50% and is predicted by the initial Glasgow Coma Scale (GCS), older age, hypotension, the development of secondary injuries/insults, and the depth and duration of coma.[4,5,7,8,9] Among survivors, neurologic impairment is unfortunately common and the socioeconomic consequences related to prolonged hospitalizations, need for rehabilitation, and permanent disabilities are tremendous.[8,10]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.