Traumatic Brain Injury: Getting our heads around it

Abstract

Moderate and severe traumatic brain injury are a common cause of death and disability in the Netherlands and pose a threat, much bigger than exsanguination and multi-organ failure, for our isolated TBI and multiple injured trauma patients. Many of these injuries are caused by falls, especially in the elderly community and amongst infants. Unfortunately, the nationwide love for cycling seems to come with its dangers, as many TBI patients suffered their injury after a bicycle accident. Research of prevention measures is recommended, as no treatment modality has proven to be effective yet and prevention may be the answer in decreasing the mortality and disability caused by TBI. Investigating possibilities for mandatory helmet use for cyclists, e-cyclists and all moped users is highly recommended. Improvement of the prehospital triage protocol is necessary to ensure transport of patients with moderate and severe TBI straight from scene of the injury to a level 1 trauma centre. Investigating options to determine functional outcome should help to determine the actual effect of treatment. Research regarding prognostication, however, is complicated by treatment-limiting decisions leading to self-fulfilling prophecies and an inability to assess functional outcome correctly.