Management of brain edema in acute head injury

Abstract

BACKGROUND: We aim was to review the basic concepts and to analyze the current management of cerebral edema following acute head trauma (AHT). METHOD: Cerebral edema should be recognized and treated early and aggressively to avoid disastrous results such as cerebral herniation. After clinical evaluation and early cardiorespiratory stabilization, the patients should be treated with the elevation of head, oxygen, mannitol, hyperventilation, and sedation-myorelaxation and may avoid from hypotension-hypoxia. If these treatments be unsuccessful, barbiturates may be used. There are also other possibilities such as hypothermia, ventriculostomy, hypertonic saline and neuroprotector agents. CONCLUSIONS: All patients with AHT should be evaluated early and cerebral edema should be treated with correct therapy. Therefore, the mortality and morbidity rates may reduce.