Crash 3. A new international effort in the management of traumatic hemorrhagic brain damage.

Despite the advances in recent decades in the monitorization, diagnosis and treatment of severe traumatic brain injury (STBI), and which have reduced mortality in the developed countries, 50% of all patients admitted to hospital due to STBI continue to suffer significant life-long sequelae. The probability of death or of sequelae is largely dependent upon the amount of brain tissue destroyed, and this in turn is conditioned by the extent of the primary damage resulting from the magnitude of the biomechanical impact and by the different causes of secondary brain lesions which inexorably worsen the outcome. Hemorrhagic lesions, in the form of intraaxial hematomas or extraaxial hematomas, are found in 50% of all STBIs and have a strong impact upon the outcome. In general, extraaxial lesions, specifically subdural hematomas and epidural hematomas, are identified from the first computed tomography (CT) scan after the traumatism, tend to be unilateral, and are mostly amenable to surgical drainage. In contrast, intraaxial lesions, in the form of intraparenchymal hematomas or hemorrhagic contusions, can be multiple,