From time to time on the Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they hit the mark on an issue, and so, we wanted to bring your attention to a recent supplement in Neurosurgery: “Brain Trauma Foundation Guidelines for the Management of Penetrating Traumatic Brain Injury, Second Edition.”
The Brain Trauma Foundation has updated the 2001 evidence-based guidelines for the care of patients with penetrating traumatic brain injury (pTBI). A working group of more than 30 expert panelists developed over 30 new evidence-based recommendations. To provide a bridge between these recommendations and the complexities of care at the bedside, panelists also used a rigorous Delphi process to develop consensus statements as well as treatment algorithms for the guidelines. The guidelines and algorithms are published together as a supplement to the March 2026 issue of Neurosurgery, the official publication of the Congress of Neurological Surgeons (CNS), which is part of the Lippincott portfolio by Wolters Kluwer.
The guidelines were reviewed for evidence-based integrity and endorsed by the American Association of Neurological Surgeons and Congress of Neurological Surgeons.
The algorithms portion of the supplement includes a toolkit for assessing futility in cases of pTBI, as well as toolkits for surgical management in general, managing a protruding foreign body, managing severe injury (multiple injured lobes, mass lesion, midline shift, or edema), managing penetrating skull base injury, and managing traumatic vascular injury.
To access the full supplement, click here.
Cover Attributions
“Inbound for Kandahar Airfield” ©Peter J. Robichaud; BTF Logo©Brain Trauma Foundation; USU/MTBI2 Logo © Uniformed Services
University; OHSU Logo © Oregon Health & Science University; MRDC. Logo courtesy of the US Army; all used with permission
