الفهرس 
Management, Monitoring, and role of differentOnly 14 pages are availabe for public view
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Abstract
Traumatic Brain Injury (TBI), a clinical problem treated frequently by medical community, is a
major cause of disability, death, and economic cost to our society. In the past two decades, we
have increased remarkably our understanding of the pathophysiology ofTBI (Bullock et al., 2000).
One of the central concepts that emerged from clinical and laboratory research is that all
neurological damage does not occur at the moment of impact, but evolves over the ensuing hours and
days (Ghajar et al., 1995).
Furthermore, we now recognize the deleterious effects of these various delayed insults to the
injured brain at the clinical and biochemical levels (Ghajar et al., 1995).
This has led to an interest in developing better monitoring and treatment methods as well as the
development of new pharmaceuticals, all of which show great promise in improving the outcome for
patients who have suffered a brain injmy (Bullock et al., 2000).
Prehospital care and emergency department treatment of patients with neurotrauma may have profound
importance in their ultimate morbidity and mortality. Many key individuals provide critically
important patient care in the early minutes and hours after trauma, including appropriately
credentialed emergency physicians, anesthesiologists, emergency medical technicians and paramedics,
and emergency department and operating room nurses, among others, whose skills and training are
essential in the management of these critically injured patients (Bullock et at., 2000).
Over the past 30 years, remarkable progress has been made in iJ?proving outcome from traumatic
brain injury (TBI). Although many etiologies for such improvement have been suggested, it is
unclear what changes actually affected the improvement in outcome. Despite the fervor for
laboratory investigations of TBI models, it is sobering to recognize that no treatments have come
from bench to bedside. As such, there are no magic bullets in the treatment of central nervous
system (CNS) trauma in general, and TBI in particular. Instead, it appears to be a combination of
many improvements in brain injury care, trauma systems, and critical care that has produced the
decrease in mortality (Chestnut, 2004).