Inclusion Criteria:  Age between 18 and 65 years Traumatic Brain Injury with abnormal CT scan Invasive ICP monitoring in place ICP >25 mmHg for 1-12h after conventional therapies step I and step II (see Trial flow chart)  Exclusion Criteria:  Bilateral fixed and dilated pupil Limitation of therapies by the team due to poor prognosis Withdrawal of consent Severe pre-existing physical or mental disability or co-morbidity which would lead to a poor outcome even if the patient made a full recovery from the head injury Intracranial injury mandating craniotomy/craniectomy in itself Intraabdominal injury mandating laparotomy in itself