TRAUMATIC BRAIN INJURY: IMPLICATIONS AND MANAGEMENT

Abstract

Traumatic brain injury (TBI) is a neurological condition resulting from an external force that causes brain damage, and is one of the leading causes of morbidity and mortality worldwide, especially among young adults. Its etiology is varied, including traffic accidents, falls, assaults, and sports accidents, and it is more frequent in urban environments and regions with a high incidence of violence. The severity of TBI varies from mild to severe, depending on the mechanism of trauma, the type of injury, and the body's response. The diagnosis of TBI is based on clinical evaluation and the use of imaging exams, such as computed tomography (CT) and magnetic resonance imaging (MRI). The initial neurological assessment should follow standardized protocols, such as the Glasgow Coma Scale, which classifies the patient's level of consciousness on a scale of 3 to 15, helping to determine the severity of the injury. Patients with mild traumatic brain injury (TBI) generally have a good prognosis, while those with moderate to severe TBI may develop serious complications, including cerebral edema, intracranial hemorrhages, herniations, and increased intracranial pressure (ICP). TBI management involves a multidisciplinary approach, prioritizing hemodynamic and respiratory stabilization, maintaining a patent airway, and controlling ICP. Pharmacological interventions include the use of hyperosmolar agents, anticonvulsants, and sedatives, in addition to surgical measures such as hematoma drainage or decompressive craniectomy, when indicated. Continuous monitoring of ICP and cerebral oxygenation is essential to prevent secondary injuries, which can worsen the neurological condition. Rehabilitation is a crucial step after the acute phase, aiming to recover motor, cognitive, and sensory functions, as well as promoting the patient's social reintegration. TBI prevention involves educational initiatives, the use of protective equipment, traffic enforcement, and improvements in urban infrastructure. The prognosis for TBI depends on the severity of the injury, the time of intervention, and the quality of support provided, with early rehabilitation significantly increasing the chances of recovery.