Factors predicting early deterioration in mild brain trauma: a prospective study
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Updated: May 7, 2026
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
Amir Saied Seddighi1, Rouzbeh Motiei-Langroudi, Homa Sadeghian
1Department of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran .
Primary Objective:
To evaluate risk factors for clinical deterioration in mild traumatic brain injury.
Research Design:
Prospective cross-sectional.
Methods And Procedures:
This study evaluated 203 patients with mild traumatic brain injury. A brain computed tomography scan was performed in all patients and they were observed for 6-48 hours.
Main Outcomes And Results:
Among these patients, 2.5% had cerebral contusions and the most common sites for contusions were frontal lobes; 94% of patients had no hematoma in the initial scan, while 3% had subgaleal haematoma, 1.5% had subdural haematoma, 1% showed subarachnoid haemorrhage, 0.5% intracerebral haemorrhage and 0.5% epidural haemorrhage. GCS was 15 in 96.6% and 13-14 in 3.4%. GCS deteriorated in three (1.5%). Presence of coagulopathy, anticoagulant drug use, GCS of 13-14 and increased age predicted further deterioration. Among CT findings, those with midline shift, cerebral contusion and diffuse cerebral oedema deteriorated more. Among different haematoma types, only SDH predicted a worse outcome.
Conclusions:
Although deterioration rarely occurs in patients with mild brain injury, those with coagulopathy, anticoagulant drug use, GCS of 13-14, increased age, midline shift, cerebral contusions, diffuse cerebral oedema and SDH were more prone to deterioration.
