The “Japan Guideline for the Management of Traumatic Brain Injury” was established in 2000, to standardize and to improve the management performance, by maintaining systemic circulation, oxygenation, and intracranial pressure. In recent years, the situations of acute TBI management are divided to develop as prehospital, primary, intensive, and professional, requiring cooperation between departments. As going through several editions of the guideline in the last couple of decades, the mortality of TBI has significantly decreased.
As the population aging, the number of the elderly patients with TBI is increasing. The characteristics of them are known as (1) increased risk of trauma, (2) increased risk of intracranial bleeding, and (3) increased risk of aggravation. Those risks are partially explained by ‘talk and deteriorate’ phenomenon, coagulopathy, and antithrombotic drugs use. Thus, efforts to address those risks may be important to improve outcome of the elderly patients with TBI.
In this article, the commitments of the “Japan Guideline for the Management of Traumatic Brain Injury” are reviewed to clarify the forthcoming challenges.
