A scoring system for severity of traumatic brain injury, based on admission noncontrast head CT scan.
Diffuse injury I – there is no visible intracranial pathology seen on CT scan
Diffuse injury II – Cisterns are present with midline shift of 0-5 mm and/or lesions densities present; no high or mixed density lesion >25 cm3 may include bone fragments and foreign bodies
Diffuse injury III (swelling) – Cisterns compressed or absent with midline shift of 0-5 mm; no high or mixed density lesion >25 cm3
Diffuse injury IV (shift) – Midline shift >5 mm; no high or mixed density lesion >25 cm3
V Evacuated mass lesion – Any lesion surgically evacuated
VI High or mixed-density lesion not surgically evacuated – High or mixed density lesion >25 cm3; not surgically evacuated
Reference: Maas AIR, Hukkelhoven CWPM, Marshall LF, Steyerberg EW. Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors. Neurosurgery. 2005 Dec.;57(6):1173-82