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Related Experiment Video

Updated: Nov 25, 2025

Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging
08:27

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

691

GCS 15: when mild TBI isn't so mild.

Latha Ganti1,2, Tej Stead3, Yasamin Daneshvar4

  • 1UCF HCA Emergency Medicine Residency Program of Greater Orlando, University of Central Florida College of Medicine, Orlando, FL USA.

Neurological Research and Practice
|December 16, 2020
PubMed
Summary

Even mild traumatic brain injuries (TBIs) with a Glasgow Coma Scale (GCS) of 15 warrant neuroimaging due to frequent CT abnormalities. This highlights the limitations of GCS in classifying TBI severity.

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Area of Science:

  • Neuroscience
  • Emergency Medicine
  • Trauma Surgery

Background:

  • Traumatic Brain Injury (TBI) classification relies on Glasgow Coma Scale (GCS).
  • The mildest TBI category (GCS 15) is often presumed to have minimal injury.
  • Characterizing patients with GCS 15 is crucial for understanding injury patterns and outcomes.

Purpose of the Study:

  • To characterize patients presenting with the mildest form of traumatic brain injury (TBI), defined by a Glasgow Coma Scale (GCS) of 15.
  • To identify predictors of adverse outcomes in this patient group.
  • To evaluate the utility of neuroimaging in patients with GCS 15.

Main Methods:

  • Observational cohort study of adult patients with TBI and GCS 15 at emergency department arrival.
  • Data collection included demographics, injury mechanisms, symptoms (vomiting, LOC, AOC, PTA), pre-hospital and ED GCS, and CT scan results.
  • Outcomes assessed: hospital admission, ICU admission, neurosurgical intervention, and in-hospital death.

Main Results:

  • Loss of Consciousness (LOC), Alteration of Consciousness (AOC), and Post-Traumatic Amnesia (PTA) predicted hospital admission (p < 0.0001).
  • ICU admission was associated with antiplatelet/anticoagulant use, PTA, LOC, and abnormal CT scans.
  • Patients who died had intracranial hemorrhage on CT despite GCS 15, and were more likely to be on antiplatelet/anticoagulants and have experienced vomiting.

Conclusions:

  • Neuroimaging is essential for all TBI patients, including those with GCS 15, as 10% in this cohort had abnormalities.
  • GCS score alone is insufficient for classifying TBI severity, as even mild TBIs can present with significant CT findings.
  • Findings underscore the need for thorough evaluation and imaging in patients with seemingly mild TBI.