Traumatic Brain Injury in Adults
Traumatic Brain Injury in Adults
The Society of British Neurological Surgeons TBI working party recommends that patients with isolated mild TBI are best managed on observation wards under the care of emergency department staff. The objective of hospital admission for patients who do not require transfer to a NSU is to continue neurological observations, allow time for improvement in patients' symptoms and to identify the small subset of patients who deteriorate. Patients usually require admission if they have an abnormal CT head scan (but do not require transfer to a neuroscience centre), GCS less than 15 regardless of CT findings or persistent symptoms (eg, vomiting, severe headaches, CSF leak). In general, patients can be discharged when their GCS has returned to the pre-injury level and major symptoms have resolved. The NICE guidelines recommend that all patients should be referred to their general practitioner for follow-up within 1 week after discharge.
When to Admit and Discharge Patients After TBI?
The Society of British Neurological Surgeons TBI working party recommends that patients with isolated mild TBI are best managed on observation wards under the care of emergency department staff. The objective of hospital admission for patients who do not require transfer to a NSU is to continue neurological observations, allow time for improvement in patients' symptoms and to identify the small subset of patients who deteriorate. Patients usually require admission if they have an abnormal CT head scan (but do not require transfer to a neuroscience centre), GCS less than 15 regardless of CT findings or persistent symptoms (eg, vomiting, severe headaches, CSF leak). In general, patients can be discharged when their GCS has returned to the pre-injury level and major symptoms have resolved. The NICE guidelines recommend that all patients should be referred to their general practitioner for follow-up within 1 week after discharge.