Emergency Medicine Book

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Management of Moderate Head Injury

Aka: Management of Moderate Head Injury, Moderate Head Injury, Moderate Head Trauma
  1. See Also
    1. Head Injury
    2. Management of Mild Head Injury
    3. Management of Severe Head Injury
  2. Signs
    1. Glasgow Coma Scale: 9-12 (at two hours)
    2. Confused or somnolent
    3. Follows simple commands
  3. Evaluation: Initial
    1. Same as in Management of Mild Head Injury
    2. CT Head in all cases
    3. Admit all for observation (or Transfer to Neurosurgery)
  4. Evaluation: Inpatient Monitoring
    1. Frequent neurologic checks
    2. Follow-up CT Head in 12-24 hours
      1. Condition deteriorates or
      2. First CT abnormal or
      3. Per local protocol before discharge
  5. Disposition
    1. Patient improves (80-90%)
      1. Discharge after 48 hours
      2. Follow-up clinic
    2. Patient deteriorates (10-20%): Not following commands
      1. Repeat CT Head
      2. Follow Management of Severe Head Injury protocol

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