Classification of Head Injury

Head injuries can be categorized in several ways: by mechanism of injury (closed or penetrating injury), morphology (fractures, focal intracranial injury, diffuse intracranial injury), or severity of injury (mild to severe). Immediate triage and assessment of the severity and probable survival of the traumatized patient should be made whenever possible already at the scene of injury. Of useful help are the various trauma scores that have been developed to triage the patients for proper care and evaluate the severity of injury. The scores are based on physiological and/or anatomical features, as well as patient responses. Physiological scores are exempli fi ed by Glasgow Coma scale (GCS) (Teasdale and Jennett 1974 ) , the Revised Trauma Score (RTS) (Champion et al. 1989 ) , and the Pediatric Trauma Score (PTS) (Tepas et al. 1987 ) . The Injury Severity Score (ISS) is an anatomical score based on the Abbreviated Injury Scale (AIS) that provides an overall score of the patient (Baker et al. 1974 ) . The GCS has been the most valuable and frequently used scoring system for assessing the severity of a head trauma. To estimate severity of brain injury after head trauma, various classi fi cation systems of head injury have been proposed and modi fi ed throughout the years. Most of them are based on the patients’ level of consciousness according to the GCS, as e.g. the Head Injury Severity Scale (HISS) (Stein and Spettell 1995 ) . The Swedish Reaction Level Scale 85 (RLS) is a somewhat