Operative treatment in head injury.

Improved outcome will result only from improvement in the total care of the head-injured patient. Each aspect of care is dependent on the other: rescue services; aggressive emergency evaluation and resuscitation; monitoring of the patient's physical, chemical, and neurological status; CT scanning; and intensive medical therapy and early rapid surgical decompression. The injured brain is particularly prone to further secondary insults. Intracranial mass lesions must be removed quickly and thoroughly; the brain should be handled in a careful and gentle fashion intraoperatively, and medical complications should be prevented. Dysfunctional cells in a marginal state can only be expected to return to normal with the proper management and environment.