Traumatic brain injury

A 46-year-old intoxicated man was driving down the highway in the wrong direction when his vehicle struck a pickup truck head-on. He presented with a pulse rate of 130 beats/ minute, blood pressure of 90/ 62 mm Hg, and respiratory rate of 32 breaths/ minute. His pupils are 5 mm and are equally round and reactive to light bilaterally; he does not open his eyes to painful stimuli, moans with painful stimuli, and withdraws from painful stimuli. His oxygen saturation with oxygen by face mask is 86%.