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Brain Injury Treatment - Acute
How are Severe Brain Injuries Treated?
Source: Centers for Disease Control 2004 
From The Ashes:
A Brain Injury Survivor's Guide
Spanish / Español  (Información Acerca de la Lesión Cerebral Leve) 

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The goals of brain injury treatment are to: 
  • Stop any bleeding 
  • Prevent an increase in pressure within the skull 
  • Control the amount of pressure, when it does increase 
  • Maintain adequate blood flow to the brain 
  • Remove any large blood clots
Treatments will vary with the type of injury. The doctor will decide which ones are used. Some common treatments are:
  • Positioning: Usually the head of the bed will be elevated slightly and the neck kept straight. This position may decrease the intracranial pressure by allowing blood and cerebrospinal fluid (CSF) to drain from the brain. Please do not change the position of the bed without asking the nurse.
  • Fluid Restriction: It may be necessary to limit the fluids that a patient receives. The brain is like a sponge. It swells with extra fluid. Limiting fluids can help control the swelling. Please do not give fluids without asking the nurse.
  • Medications: There are several types of medications used to treat brain injury. Some of these include: 
    • Diuretics are used to decrease the amount of water in the patient's body. This makes less water available to the brain for swelling. 
    • Anticonvulsants are used to prevent seizures. Seizures occur as a result of extra electrical activity in the brain. There are several types of seizures. The most common type causes the patient to have jerking movements of the arms and legs followed by sleep. 

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      Other types may cause slight tremors of the face, or staring spells. Please notify the nurse or doctor if you see any of these signs. Some patients have a seizure at the time of injury while others may develop seizures after the injury. 

    • Barbiturates are given if the patient's intracranial pressure is very high and hard to control. This medicine puts the patient into a deep "sleep" called a barbiturate coma. This may help prevent more swelling and damage. 
    • Ventricular Drain (Ventriculostomy): A small tube is placed in the ventricle. It measures and controls pressure inside the skull. It can be used to drain some CSF (cerebrospinal fluid) from the brain.
    • Ventilator: A machine used to support the patient in their own breathing, or give the patient breaths. When the ventilator gives extra breaths, the blood vessels in the brain become smaller. This may help control the intracranial pressure. 
  • Surgery: There are three types of surgery used with brain injury:
    • Craniotomy - The skull is opened to relieve the causes of increased pressure inside the skull. Causes may be fractured bones, blood clots, or swollen brain tissue. 
    • Burr holes - A small opening is made into the skull to remove blood clots. 
    • Bone flap removal - A piece of bone is removed from the skull to relieve pressure caused by swollen brain tissue
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