Head Injury (Traumatic Brain Injury)

👤 Who gets it

Falls, road-traffic collisions and assaults; higher risk on anticoagulants, in the elderly and with alcohol.

🔎 Work-up / diagnosis

1. 1ABCDE and protect the cervical spine; record GCS and pupils; examine for scalp/skull injury and other trauma.
2. 2Apply a validated CT-head rule (e.g. GCS <15 at 2 h, suspected open/depressed/basal fracture, ≥2 vomits, focal deficit, seizure, coagulopathy).

🧭 Management — overview

• ✓Prevent secondary injury: maintain oxygenation and blood pressure — avoid hypoxia and hypotension.
• ✓Manage raised ICP: head up ~30°, analgesia/sedation, treat seizures, and neurosurgical measures (hyperosmolar therapy, evacuation) for significant haemorrhage.
• ✓Reverse anticoagulation for intracranial bleeding; admit for observation where indicated.
• ✓Concussion: rest with a staged return to activity; give written safety-net advice to all discharged patients.

📚 References

• ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗
• WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

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