Traumatic brain injury is one of the most difficult and challenging management problems facing clinicians. The last 20 years have seen major advances in the prevention and treatment of head injury, resulting in a substantial decrease in associated mortality. In the 1970s, 50% of patients with severe head injuries died as a result. In the 21st century mortality rates of around 25–30% are commonly reported. There has been a concomitant increase in the number of good to moderately disabled survivors as opposed to those left severely disabled or vegetative. This improvement is due to several factors, including better patient retrieval and resuscitation, enhanced emergency facilities and early surgery. However, head injury remains a major health and social problem both for developed and developing nations. Research is increasingly clarifying the underlying physiological mechanisms involved in neuronal damage, offering the chance of better methods of diagnosis and treatment. There has been particular interest in the development of neuroprotective agents.
This is a comprehensive and extensively updated guide to the management of severe head injury. It provides a complete management framework for traumatic brain injury and is divided into three sections covering mechanisms of injury, quantification and monitoring, and treatment of the injury. There is detailed coverage of the relevant basic sciences, which then leads on to more clinical aspects with particular emphasis on the rapidly evolving areas of neuromonitoring and neuroprotection.
It is extensively referenced and well‐illustrated. The contributors come from a wide range of clinical and scientific disciplines with an international perspective, resulting in a balanced contemporary review of our current knowledge and understanding of head injury. Some of the illustrations suffer from being out‐dated in style but this is compensated for by a section of colour‐plates.
It would be a useful reference addition to the library of neurosurgeons, trauma surgeons and intensivists responsible for the care of head injured patients.