An update on the management of traumatic brain injury.

The management of traumatic brain injury (TBI) continues to evolve in a number of key areas. In the first instance there have been major advances in clinical information gathering and interpretation such that there are mow sophisticated prognostic models readily available. Secondly, technological advances have allowed the introduction of advanced multimodal monitoring which can provide real time information regarding the complex physiological and biochemical derangements that occur following TBI. Finally recent clinical trials have raised important questions regarding the efficacy or otherwise of important therapeutic options most notably hypothermia and decompressive craniectomy. The aim of this update is to highlight some of the areas where there has been advancement and controversy.