Trauma is the most common cause of death for those in the under 45s (1). Traumatic brain injury (TBI) remains the cause of approximately half of the trauma deaths. Worldwide, trauma is increasing at epidemic proportions with the World Health Organization predicting road traffic accidents being the fifth most common cause of death and disability by 2030 (2). Primary injury (occurring at the time of impact) can only be reduced by public health policy and safety prevention measures. This has to be the main focus for resource-poor countries in which trauma is increasing so dramatically. Secondary injury (the brain insults that occur following the impact) includes, amongst other problems, hypoxia, hypotension, further injury from compression (e. g. expanding haematoma), intracranial hypertension, seizures and infection. The secondary insults following an impact can be prevented and minimised with high quality neurotrauma care. To achieve such an aim, a multidisciplinary approach requiring integrated prehospital, emergency, neurosurgical, intensive and rehabilitative care is required.