Traumatic Brain Injury: Advances in Diagnostic Techniques and Treatment Modalities

Abstract

Background/Objectives: Traumatic brain injury (TBI) is a major global cause of death and disability, with long-term cognitive, behavioral, and functional consequences. Despite its high burden, management is complicated by heterogeneous presentations and limited evidence. This review summarizes recent advances in monitoring, therapeutic strategies, neuroprotection, and rehabilitation, while highlighting future directions toward individualized and globalized care. Methods: This paper is a narrative review of clinical trials, systematic reviews, and observational studies, focusing on invasive and non-invasive monitoring, pharmacologic and non-pharmacologic interventions, neuroprotective agents, stem cell therapy, and advanced rehabilitation modalities. Results/Findings: Our review focuses on emerging monitoring techniques, including brain tissue oxygenation, cerebral microdialysis, and multimodal strategies, that provide detailed insights but lack standardized application. Interventions such as anti-inflammatory agents, hypothermia, hyperosmolar therapies, and metabolic suppression show mixed efficacy, with few therapies supported by high-level evidence. Novel agents like erythropoietin and progesterone demonstrate neuroprotective potential in preclinical models but remain inconclusive in clinical trials. Stem cell therapies and extracellular vesicle approaches are promising in early studies. Rehabilitation is expanding with virtual reality, robotics, and neurostimulation to promote neuroplasticity. Personalized medicine approaches incorporating biomarkers and machine learning may refine prognostication and guide therapy. Global inequities persist, particularly in low-resource settings. Conclusions: TBI care is shifting toward individualized, multimodal, and technology-driven strategies. While emerging therapies show promise, high-quality randomized trials and global implementation strategies are needed to improve outcomes and reduce disparities.