Traumatic brain injury and neurocritical care

It is almost guaranteed that every deployed surgeon will deal with brain-injured casualties. It is one of the most common injuries encountered in combat, and every surgeon must be trained in the initial management of traumatic brain injuries (TBI). Even at lower levels of care, you may get "stuck" managing casualties who cannot be evacuated, and it may be necessary for the initial stabilization to progress into ongoing neurocritical care and even possibly a decompressive craniectomy. Even when evacuation to a neurosurgeon is possible, the initial management is critical to the long-term outcome. In current operations, immediate access to a neurosurgeon is more of a luxury than a given, and the combat surgeon must be prepared to provide full-spectrum management of TBI.