Snapshot A 38-year-old male presents to the ED after a motorcycle accident where he was flung from his seat and hit his head on a nearby pole. He was not wearing a helmet. Miraculously, paramedics found him early without any other injuries, albeit unconscious. He is on a backboard, bag-mask ventilated with an oropharyngeal airway and a C-spine collar as he enters the trauma bay. His blood pressure is 140/80 mmHg, pulse is 100/min, respirations are 22/min, and SaO2 of 95% on room air. Glasgow Coma Scale score is 3, with the left pupil that is 3 mm more dilated than his right. He is endotracheally intubated, sedated with propofol, the head of his bed is risen to 30°, and hyperventilated to 30 breaths/min while mannitol infusions are prepared. Immediate head CT reveals a left subdural hematoma with midline shift. ABG reveals pH 7.45, pCO2 32 mmHg. The patient is wheeled to the OR for emergent craniotomy. Introduction Almost 2/3 of trauma admissions have head injuries login to view 1 more bullet Neurotrauma includes injuries to skull, facial, scalp, brain, and spinal cord login to view 32 more bullets Presentation Clarify mechanism of injury and mental status before arrival to ED login to view 9 more bullets Vital signs login to view 4 more bullets Physical exam login to view 7 more bullets Evaluation Primary and seconary survey with resuscitation Investigations login to view 5 more bullets Spinal immobilization (C-spine collar) login to view 9 more bullets Management Acute neurotrauma login to view 12 more bullets Spinal cord injury login to view 7 more bullets Mild TBI/concussion login to view 4 more bullets Other considerations login to view 2 more bullets