Traumatic brain injury (TBI) is defined as an acute injury to the head caused by blunt or penetrating trauma or from acceleration/deceleration forces excluding degenerative, congenital problems. (1,2) India carries the highest number of traumatic brain injuries when compared to the rest of the world. With scant research from the West and India, it was determined that these head injuries result in substantial pain and loss for patients, households, and societies. (3) Brain injury healing takes years, based on the extent of pathological trauma and physiological causes. At the global level, the annual occurrence and mortality rate from Traumatic Brain Injuries are estimated to be 200 & 20 per 100,000, respectively. (4) As is the case in many developing countries, India lacks national-level statistics on traumatic brain injury. The authors' single epidemiological analysis in Bangalore revealed rates of prevalence, death, and case fatality of 150/1,00,000, 20/1,00,000, and 10%, respectively. (5,6) Per year, almost 2 million people suffer brain damage, 0.2 million die, and almost a million need physiotherapy and rehabilitation as an outpatient every year. Numerous intracranial pathologies such as an intraparenchymal contusion, subdural hematoma, extradural hematoma, and diffuse cerebral edema may occur as a result of traumatic brain injury. These pathologies may result in elevated intracranial pressure, disturbed cerebral blood flow, and cerebral perfusion pressure, both of which may result in secondary brain damage and cerebral edema. The primary goal of therapy is to interrupt the vicious loop of cerebral edema development by monitoring initial swelling and ensuring a sufficient flow of blood, oxygen & metabolites to the affected brain tissue. Following primary care and initial resuscitation, definitive and advanced therapy is initiated to minimize and monitor secondary insults that could exacerbate brain edema and damage. Although most patients can be successfully managed by medical measures alone, some of the patients with moderate to severe TBI will continue to deteriorate due to poorly controlled progressive edema. In these patients, urgent reduction of intracranial pressure by surgical decompression of the brain is a potential lifesaving option.