Traumatic Brain Injury (TBI): Current Diagnostic and Therapeutic Challenges

Abstract

Traumatic brain injury (TBI) is a common cause of death and disability in the United States and, particularly, in the United States (US) military. This chapter will focus on current diagnostic and therapeutic challenges associated with the evaluation and care of patients with TBI. Most TBIs are mild and cause an alteration in the level of consciousness as a result of physiologic rather than structural injury. The diagnosis of mild TBI (mTBI) is subjective and currently relies heavily on patient self-report. While mTBI may cause only a brief alteration of consciousness, it can, nonetheless, result in functional changes. If the TBI is moderate or severe, causing prolonged alteration or loss of consciousness, the diagnosis is usually straightforward, although the course of recovery can be fraught with a variety of challenges. The chapter will also include a discussion of innovative, and in some cases controversial, pharmacotherapies.