DIAGNOSTIC AND THERAPEUTIC MEASURES AFTER SEVERE HEAD-INJURY IN THE INTENSIVE-CARE UNIT

Diagnostic and therapeutic measures after severe head-injury in the in tensive care unit are discussed. The main goal of all efforts consists in minimizing secondary brain damage. Adequate shock therapy in the i nitial phase proves crucial for the later outcome. Methods and indicat ions of intracranial pressure monitoring are described. Electrophysiol ogical tests, transcranial doppler sonography, EEG and serial CCT cont rols provide valuable additional information. Frequent clinical assess ments however remain the golden standard despite all technical advance s. Surgical and conservative modalities of therapy are further examine d. Controversial methods (barbiturates, steroids, some osmotic active agents) as well as new concepts of therapy are also included. The clin ician is provided with a critical discussion of the value of the diffe rent methods from our point of experience.