Neurosurgical management in traumatic brain injury.

Severe traumatic brain injury (TBI) is one of the most complex and diverse pathologic medical conditions. Each year, approximately 100,000 patients require neurosurgical evacuation of an intracranial hematoma in the United States. It is essential, early in the clinical course, to distinguish those patients with severe TBI who require operative intervention from those who can be managed with only conservative measures. The surgical technique employed is determined primarily by the specific underlying pathology in conjunction with the patient's other comorbidities.