The information contained in the Brain Trauma Foundation Guidelines for the Management of Penetrating Traumatic Brain Injury (2^nd Edition) reflects the current state of knowledge at the time of publication. The Brain Trauma Foundation, the Military Traumatic Brain Injury Initiative, and other collaborating orga-nizations are not engaged in rendering professional medical services and assume no responsibility for patient outcomes resulting from application of these general recommendations in specific patient circumstances. Accordingly, the Brain Trauma Founda-tion and the Military Traumatic Brain Injury Initiative note that adherence to these clinical practice guidelines will not necessarily assure a successful medical outcome. The information contained in these guidelines reflects published scientific evidence at the time of completion of the guidelines and cannot anticipate subsequent findings and/or additional evidence and therefore should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same result. Medical advice and decisions are ap-propriately made only by a competent and licensed physician who must make decisions in light of all the facts and circumstances in each individual and particular case and on the basis of availability of resources and expertise. Guidelines are not intended to sup-plant physician judgment with respect to particular patients or special clinical situations and are not a substitute for physician-patient consultation. Accordingly, the Brain Trauma Foundation and the Military Traumatic Brain Injury Initiative consider ad-herence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient's individual circumstances. The views expressed in this document do not reflect those of the Uniformed Services University of Health Sciences, the Military Traumatic Brain Injury Initiative, the United States Army Medical Research and Development Command, the United States Army/Navy/Air Force/Marine Corps, the Department of Defense, and the United States Government.