Related Experiment Video
Updated: Aug 23, 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
Clinical course of mild traumatic brain injury in polytrauma patients admitted to intensive care
Yehia El Bendary1, Cornelia Hounkonnou2,3, Caroline Jeantrelle4
11Neurosurgery Department, Beaujon Hospital, AP-HP Nord, Clichy.
Objective:
Mild traumatic brain injury (mTBI) accounts for the majority of TBI cases. In polytrauma patients admitted to intensive care units (ICUs), mTBI may be associated with more severe clinical profiles and a higher risk of intervention. However, the outcomes and characteristics of this population remain underdescribed.
Methods:
The authors conducted a retrospective study of adult patients with mTBI (Glasgow Coma Scale [GCS] score ≥ 13) admitted to the ICU of a level I trauma center from 2011 to 2017. Patients with secondary neurological deterioration prior to ICU admission were excluded. The authors specifically assessed the presence of intracranial lesions, need for neurosurgical interventions, and clinical outcomes including in-hospital mortality. Statistical analyses included descriptive statistics, univariate comparisons, and multivariate logistic regression models to identify factors independently associated with neurosurgical intervention and mortality.
Results:
Among 244 patients (82% male, mean age 41.3 years), 82.8% had traumatic intracranial lesions. Neurosurgical intervention was required in 22.1% of cases, and the mortality rate was 3.3%. Subarachnoid hemorrhage, subdural hematoma, and epidural hematoma were the most common imaging findings. Independent predictors of neurosurgical intervention included epidural hematoma, midline shift > 5 mm, and assault-related trauma. Mortality was associated with age and hemorrhagic shock. Functional outcomes were favorable in most patients, but 24% had disability at discharge.
Conclusions:
In polytrauma patients admitted to the ICU, mTBI is often accompanied by intracranial injuries and a substantial need for surgical intervention, even when the GCS score is high.
Insights
Mild traumatic brain injury (mTBI) in polytrauma patients often involves intracranial lesions and requires neurosurgical intervention, even with high Glasgow Coma Scale scores. Outcomes vary, with some patients experiencing disability at discharge.
Area of Science:
- Trauma Surgery
- Neurosurgery
- Intensive Care Medicine
Background:
- Mild traumatic brain injury (mTBI) constitutes the majority of traumatic brain injury (TBI) cases.
- In polytrauma patients within intensive care units (ICUs), mTBI may present with severe clinical features and increased intervention needs.
- Characteristics and outcomes of mTBI in polytrauma ICU patients are not well-documented.
Purpose of the Study:
- To describe the characteristics and outcomes of mTBI patients admitted to the ICU.
- To identify factors associated with neurosurgical intervention and mortality in this population.
Main Methods:
- Retrospective study of adult mTBI patients (Glasgow Coma Scale [GCS] score ≥ 13) in a level I trauma center ICU (2011-2017).
- Exclusion of patients with pre-ICU neurological deterioration.
- Assessment of intracranial lesions, neurosurgical interventions, and in-hospital mortality using descriptive statistics, univariate comparisons, and multivariate logistic regression.
Main Results:
- 82.8% of 244 patients had intracranial lesions; 22.1% required neurosurgical intervention; mortality was 3.3%.
- Common findings included subarachnoid hemorrhage, subdural hematoma, and epidural hematoma.
- Predictors for neurosurgical intervention were epidural hematoma, midline shift > 5 mm, and assault trauma. Age and hemorrhagic shock predicted mortality. 24% had discharge disability.
Conclusions:
- mTBI in polytrauma ICU patients frequently involves intracranial injuries.
- A significant proportion of these patients require surgical intervention, irrespective of initial GCS score.
- Understanding these outcomes is crucial for managing polytrauma patients with mTBI.
