Pathophysiology of Brain Injury: An Overview

During the last decade there was a decrease in mortality of severe brain injuries. In the same period the morbidity in brain-injured patients improved in our clinical experience. The publication on interactions between factors determining prognosis in populations of patients with severe head injury presented by Braakman [4] and the limits to classification and prognosis of severe head injury described by Frowein and coworkers [11] started with a large data bank on head-injured patients to observe prediction factors and prognosis. These studies led to better classifications of head injury and the limits set for clinically based prognosis and recovery. The Glasgow Coma Scale, introduced by Teasdale and Jennett in 1974, has become the ‘gold standard’ in the assessment of head injuries.