Traumatic Brain Injury (TBI): Assessment and Early Management

Source: Traumatic Brain Injury presentation by Daniel Stone, MD

Traumatic Brain Injury: Early Recognition, Imaging, and Management

Traumatic brain injury is a time-sensitive medical emergency with potentially devastating consequences. Early recognition and appropriate management can significantly alter outcomes, particularly in children and vulnerable populations.

This session provides a structured approach to evaluating, imaging, and managing TBI in emergency and acute care settings.

Defining Traumatic Brain Injury

TBI is defined by a disruption in brain function caused by an external force. Diagnosis may be clinical, radiographic, or both. Even mild injuries can progress, making early vigilance essential.

The Role of the Glasgow Coma Scale

The Glasgow Coma Scale remains a cornerstone of TBI assessment. This presentation reviews proper scoring, interpretation, and the limitations of relying on a single point-in-time assessment.

Severity classifications include:

Mild TBI (GCS >13)

Moderate TBI (GCS 8–13)

Severe TBI (GCS <8)

Imaging and Risk Stratification

CT imaging plays a central role in diagnosing intracranial injury. The session reviews:

Common intracranial hemorrhage patterns

Signs of midline shift, herniation, and cerebral edema

Pediatric and adult imaging decision rules

Initial Management Priorities

Early management focuses on airway protection, oxygenation, blood pressure control, normoglycemia, and prevention of secondary brain injury. The importance of temperature management and rapid recognition of herniation syndromes is emphasized.

Slides: (Link to PowerPoint here)