Related Experiment Video

Updated: May 9, 2026

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
09:49

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury

Published on: January 20, 2023

Delayed neurological deterioration after mild head injury: cause, temporal course, and outcomes

Osamah J Choudhry1, Charles J Prestigiacomo, Nihar Gala

  • 1*Department of Neurological Surgery; ‡Department of Radiology; and §Division of Trauma Surgery, Department of Surgery, UMDNJ--New Jersey Medical School, Newark, New Jersey.

Neurosurgery
|July 23, 2013
PubMed
Abstract

Insights

Delayed neurological deterioration (DND) after mild head injury with intracranial hemorrhage is uncommon (4.1%) and typically occurs within 24 hours. Progressive hemorrhage is a leading cause of DND, resulting in significant morbidity and mortality.

Area of Science:

  • Neurotraumatology
  • Neurosurgery
  • Emergency Medicine

Background:

  • Mild head injury (MHI) with intracranial hemorrhage (ICH) is a frequent reason for hospital admission post-trauma.
  • Most patients with MHI and ICH are managed nonoperatively and recover well.
  • Delayed neurological deterioration (DND) occurs in a small subset of patients, with limited understanding of its characteristics.

Purpose of the Study:

  • To determine the causes, timing, and outcomes of DND in patients with MHI and ICH.
  • To identify factors contributing to neurological decline after initial stabilization.

Main Methods:

  • Retrospective review of adult patients with MHI and ICH over 54 months.
  • Inclusion criteria: nonoperative management post-initial CT, and subsequent DND (Glasgow Coma Scale score decrease ≥2).
  • Data collected: demographics, neurological status, clinical course, radiographic findings, and outcomes.

Main Results:

  • 31 out of 757 patients (4.1%) experienced DND.
  • 87% of DND events occurred within 24 hours of admission.
  • Progressive ICH caused DND in 68% of cases; medical causes in 32%.
  • Mortality was associated with age >60, coagulopathy, and changes in Marshall CT classification.

Conclusions:

  • DND following MHI with ICH is infrequent, with most cases occurring within 24 hours.
  • Progressive intracranial hemorrhage as a cause of DND leads to substantial morbidity and mortality.
  • Further research is essential to identify risk factors for early detection and improved patient outcomes.

More Related Videos

Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging08:27

Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging

Published on: April 11, 2025

Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury10:59

Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury

Published on: November 19, 2012

Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
Spinal Cord Injury ll: Pathophysiology01:14

Spinal Cord Injury ll: Pathophysiology

Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
Dementia l: Introduction01:22

Dementia l: Introduction

Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...