**6. Conclusions**

In summary, patients with concomitant TBI and haemorrhagic shock usually sustain multisystem injuries that need an urgent and comprehensive team approach and may receive excellent pre-hospital care wherever possible. Although in most patients with TBI, shock is caused by haemorrhage, TBI can cause shock, particularly in the paediatric population. In either circumstance, the main objective is early identification of the underlying pathology and comprehensive management of responsible pathologies to improve outcomes. In traumatic intracranial pathologies, there may be a mismatch between systemic blood pressure and intracranial pressure that needs to be closely monitored to maintain optimal cerebral perfusion pressure.
