Core Principles and Clinical Pitfalls in Traumatic Brain Injury Management: Jorge G. Ortiz-Garcia, MD, FAAN

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"In the trauma bay, the neurologist’s main role is to identify and advocate for the patients early. Early identification of traumatic brain injury helps with functional outcomes in the future. Identify the patients who need to have an invasive monitoring device and treat the intracranial pressure and the cerebral perfusion pressure since the beginning."

At the 2026 American Academy of Neurology (AAN) Annual Meeting, held April 18–22 in Chicago, Illinois, the session “Neurotrauma Consults: What to Do When the Brain Doesn’t Answer During the ICU Calls?” focused on evidence-based approaches to acute neurotrauma care and inpatient consultation. Jorge G. Ortiz-Garcia, MD, FAAN, introduced the course by outlining key principles for neurologists managing traumatic brain injury (TBI) from the trauma bay through the ICU and into follow-up care, emphasizing adherence to established guidelines and the importance of early clinical recognition and intervention.¹

Subsequent presentations addressed practical applications of disorders of consciousness frameworks and ICU decision-making in neurotrauma. Sama Astani, MD, reviewed the use of AAN and American Congress of Rehabilitation Medicine guidelines to improve diagnostic accuracy and prognostication in patients with altered mental status who were not awakening as expected. Aarti Sarwal, MD, FAAN, discussed neuromuscular complications in spinal cord injury, including assessment of diaphragmatic function in critically ill patients. The session concluded with an interactive expert panel and closing reflections that highlighted the need for structured, multidisciplinary approaches to complex neurotrauma cases in the ICU setting.

Following the session, Ortiz-Garcia, a neurologist at the University of Oklahoma Medical Center, sat down with NeurologyLive^® at AAN 2026 to discuss the evolving clinical approach to TBI. He underscored the importance of early recognition and intervention in the trauma bay. He also emphasized the growing role of multimodal monitoring in guiding treatment decisions beyond isolated intracranial pressure and cerebral perfusion pressure values. He stressed continuous reassessment, timely escalation of care, and early initiation of rehabilitation, and cautioned against common pitfalls such as overreliance on imaging and premature prognostication.

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REFERENCES
1. Ortiz-Garcia JG. Neurologist on Call From the Trauma Bay to the Clinic? What Should I Know About Brain Trauma Guidelines?. Presented at: 2026 AAN Annual Meeting; April 18-22; Chicago, Illinois.