Traumatic brain injury is a condition of major public health importance due to the increasing incidence of traumatic brain injury all over the world (both in developed and developing countries). In developed countries, the major causes of TBI are falls (mostly in the elderly) while the major causes of TBI in developing countries are due to accidents (mainly traffic accidents and mostly in young and active population). Although, few countries have a standard epidemiological monitoring system on TBI, the mortality of TBI is still on the rise worldwide. Even with the hi-tech gadget available in the most hospitals today, the effectiveness of most TBI treatments have not been proven scientifically (i.e. a general consensus has not been reached by scientists) and most treatments are employed empirically. The disease burden of severe intracranial trauma is seriously high in Hungary especially among middle aged men being leading cause of death in the young, active population. Because of the limited knowledge on pathomechanisms elicited by head injury, the potential of personalized therapy is still restricted. The adherence to guidelines relying on well characterized effectiveness of certain clinical interventions is the most effective approach to diminish this increasing mortality. The fatal outcome is unacceptably high and has not been improved in Hungary in the last decade, and the insufficiency of rehabilitation is more pronounced among older patients. The adaption of guidelines did not improve the prognosis most probably due to the low adherence of its application. The Hungarian experiences demonstrated that the guideline potential cannot be exploited without proper auditing.