Intracranial Pathology (CT+) in Emergency Department Patients with High GCS and High Standard Assessment of Concussion (SAC) Scores

Kenneth C. Curley, Brian J. O'Neil, Rosanne Naunheim, David W. Wright

Research output: Contribution to journalArticle

Abstract

Objective: To demonstrate that a subpopulation of patients with mild/moderate traumatic brain injury (TBI) had intracranial pathology despite having a Glasgow Coma Scale (GCS) score of 15 and a Standardized Assessment of Concussion (SAC) score of 25 or higher. Setting: A network of 11 US emergency departments (ED) enrolling patients in a multisite study of TBI. Participants: Men and women between the ages of 18 and 85 years admitted to a participating ED having sustained a closed head injury within the prior 72 hours and a GCS score of 13 to 15 at the time of enrollment. Design: Prospective observational study. Main Measures: GCS, SAC, computed tomography (CT) positive or negative for intracranial pathology, Marshall scoring of CT scans. Results: Of 191 patients with intracranial pathology (CT+) and having a SAC score recorded, 24% (46/191) had a SAC score in the normal range (≥25) as well as a GCS score of 15. All causes of CT+ brain injury were present in both SAC groups. Conclusion: A normal GCS score and a SAC score do not exclude the possibility of significant intracranial injury.

Original languageEnglish
Pages (from-to)E61-E66
JournalJournal of Head Trauma Rehabilitation
Volume33
Issue number3
DOIs
StatePublished - Jan 1 2018

Keywords

  • CT
  • TBI
  • assessment
  • brain bleed
  • concussion
  • neurocognitive testing
  • traumatic hematoma

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