ABSTRACT
The estimated incidence of head injury is 430/100 000 of population. There are approximately one million patients in the UK who present to hospitals each year with head injuries. Males outnumber females by more than 2:1 and over 50 per cent of admitted patients are younger than 20 years. The classical division of brain injury is into primary and secondary damage. This division is clinically useful. Primary brain damage occurs at the time of the injury, produces its clinical effect immediately and has proved resistant to most treatments. The hyperosmolar effect of osmotic diuretics causes a transient increase in intravascular volume. However, diuresis is induced which may cause hypotension in a partially compensated multi-trauma victim. Traumatic intracerebral haemorrhage may be related to cerebral contusion or result from penetrating injuries. Patients have a high risk for relapse if a focal brain injury has been defined.
