The presence of a severe brain injury may not be immediately obvious at presentation, so a heightened clinical suspicion and early CT imaging is critical
Lesions can equally evolve rapidly and insidiously; an early discussion with specialist centres should take place
ICP should be treated in a stepwise manner in close collaboration with neurosurgical colleagues
Treatment escalation can occur in a matter of hours, such that some elements may be skipped for pragmatism
A sustained rise in ICP can both lead to a catastrophic decrease in cerebral blood flow and herniation of brain structures, resulting in brain death
