• See Also
  1. Head Injury
  2. Management of Mild Head Injury
  3. Management of Severe Head Injury
  • Signs
  1. Glasgow Coma Scale: 9-12 (at two hours)
  2. Altered Level of Consciousness
    1. Prolonged loss of consciousness (>30 minutes)
    2. Confused or somnolent
    3. Follows simple commands
    4. Restlessness or Agitation
  3. Neurologic deficits
    1. Extremity weakness or numbness
    2. Slurred speech
    3. Coordination loss
  • Evaluation
  • Initial
  1. Same as in Management of Mild Head Injury
  2. CT Head in all cases
  3. Admit all for observation (or Transfer to Neurosurgery)
  • Evaluation
  • Inpatient Monitoring
  1. Frequent neurologic checks
  2. Follow-up CT Head in 12-24 hours
    1. Condition deteriorates or
    2. First CT abnormal or
    3. Per local protocol before discharge
  • Management
  1. See Management of Mild Head Injury
  2. See Management of Severe Head Injury
  • Disposition
  1. Patient improves (80-90%)
    1. Discharge after 48 hours
    2. Follow-up clinic
  2. Patient deteriorates (10-20%): Not following commands
    1. Repeat CT Head
    2. Follow Management of Severe Head Injury protocol