Which of the following are common early medical interventions for traumatic brain injury?

• A. Fluid management.
• B. Hyperosmolar therapy.
• C. Prophylaxis for infection and seizures.
• D. All of the above.

Answer: (D)

Early management of moderate-to-severe TBI focuses on preventing secondary brain injury by supporting blood flow to the brain, controlling intracranial pressure, and reducing the risk of complications. Fluid management aims to maintain adequate cerebral perfusion by avoiding hypotension and choosing appropriate IV fluids, with adjustments made to keep mean arterial pressure stable. Hyperosmolar therapy, using agents like mannitol or hypertonic saline, is used when intracranial pressure is elevated or at risk of herniation to draw fluid out of swollen brain tissue and lower ICP. Prophylaxis for infection and seizures addresses common ICU risks after brain injury: short-term anticonvulsants are commonly given in the early phase to prevent seizures, and infection prevention measures are standard in neurocritical care to reduce pneumonia and other infections that can worsen outcomes. Taken together, these are all typical early interventions in TBI care, so choosing all of the above reflects the comprehensive early treatment approach.