Skip to Main Content

For further information, see CMDT Part 24-17: Head Injury

Key Features

Essentials of Diagnosis

  • Grades of traumatic brain injury are traditionally defined by the Glasgow Coma Scale (GCS) measured 30 minutes after injury

  • GCS Criteria used are eye opening, verbal response, and motor response

    • 1 Point

      • No eye opening

      • No verbal response

      • No motor response

    • 2 Points

      • Eyes open to pain

      • Patient vocal but not verbal

      • Extension motor response

    • 3 Points

      • Eyes open to voice

      • Patients verbal but not conversational

      • Flexion motor response

    • 4 Points

      • Eyes open spontaneously

      • Patient is conversational but disoriented

      • Patient withdraws from pain

    • 5 Points

      • Eyes open spontaneously

      • Patient is oriented in verbal response

      • Patient localizes pain

    • 6 Points

      • Eyes open spontaneously

      • Patient is oriented in verbal response

      • Obeys commands

    • Total GCS score indicates severity of TBI

      • Mild: 13–15

      • Moderate: 9–12

      • Severe: ≤ 8

General Considerations

  • Trauma is the most common cause of death in young people, and head injury accounts for almost half of these trauma-related deaths

  • Head injury severity ranges from concussion to severe TBI

  • Concussion

    • Broadly defined as an alteration in mental status caused by trauma with or without loss of consciousness

    • The term is often used synonymously with mild TBI

  • Head trauma may cause cerebral injury through a variety of mechanisms (Table 24–8)

  • Central to management is determination of which patients need head imaging and observation

Table 24–8.Acute cerebral sequelae of head injury.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.