Inclusion Criteria:

- > 18 yrs

- Admitted to ICU in Capital Health region with a TBI and > 1 of the following:

- An initial resuscitated (Sys BP>90 mmHg and O2 Sat >90%) GSC of ≤ 8

- A post resuscitation (Sys BP>90 mmHg and O2 Sat >90%) GCS at presentation to the
hospital of ≤ 8 in the absence of sedation

- A post resuscitation (Sys BP>90 mmHg and O2 Sat >90%) GCS within 72 hrs of hospital
admission of ≤ 8 in the absence of sedation

- Intracranial pressure monitoring

- Decompressive craniectomy

- Presence of subfalcine, uncal, or supratentorial herniation either clinically or
radiologically

Exclusion Criteria:

- Longer than 5 days since ictus of TBI