Abstract
Summary Traumatic brain injury (TBI) is one of the leading causes of mortality and disability among relatively young patients creating a difficult problem of modern traumatology. Severe TBI can by itself pose a formidable diagnostic and therapeutic challenge. The presence of TBI as an element of polytrauma (multiple injuries) can increase dramatically the cumulative severity and complexity of trauma management. This paper discusses clinical characteristics and approaches to patients with TBI in the context of multiple simultaneous injuries. Special attention has been paid to pathophysiological aspects of TBI in polytraumatized patients causing dangerous secondary brain damage, which should be diagnosed and addressed promptly. Various aspects of simultaneous TBI and spine injuries, thoracic cavity, abdominal cavity, skeletal and other injuries have been characterized. Management of multiply injured patients with TBI should involve effective collaboration of the multidisciplinary trauma team and may require introduction of various “damage control” techniques.
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