Table 1

 Summary of case reports of mild head injury patients with GCS 15 where an early CT scan might have been normal and the patient still deteriorated within two days

Author, year, country, referenceType of studyPatient, historyTime of first CT, resultReason for new CTTime for new CT, resultIntervention, outcomeNumber of cases, remarks
Hemphill, 1999 USA,26Retrospective case series of 194 patients with late complications74 year old male, fall, salicylate therapy, no LOC or amnesia, no other symptomsEarly, normalReturns 23 hours later, comatose, GCS 3After 25 hours, subdural hematomaUnclear, died1 “false negative” case, symptom free at start, salicylate therapy
Domenicucci, 1995, Italy,27Review article with 5 original and 45 earlier published cases31 year old woman, normal neurology after car accidentAfter 4 hours, normalDepressed level of, consciousness, anisicoria, right sided weaknessAfter 21 hours, intracranial bleedingSurgery, discharged to home after10 days1 ”false negative” case, few details given
Ciquini Junior, 1992 Brazil,28Case report of two cases10 year old boy, fell from >2 metres, normal neurologyAfter 3 hours, normalGCS lowered to 14After 21 hours, extradural haematomaSurgery, discharged to home after 5 days1 “false negative” case, had both skull radiograph and CT, unclear why admitted after first CT
Culotta, 1996 USA,21Retrospective case series of 3370 patients with GCS 13–15Six cases, no other history given, GCS 15“Early”, normalNot statedNot statedSurgery, unclear6 possible cases, few details given, unclear time intervals. No further data delivered on request.
Keskil, 1995 Turkey 29Retrospective case series of 257 children with GCS 14–156 year old boy, GCS 15Unclear, not statedClinical deterioration after 2 daysAfter 2 days, diffuse cerebral swellingUnclear, died1 possible case, unclear if initial CT was carried out
Arienta, 1997 Italy, 30Retrospective case series of10000 head injuriesPatient with epilepsy admitted for observation, GCS 15Early, normalClinical deteriorationUnclear, intracranial haemorrhageUnclear, unclear1 possible case, few details given, unclear time intervals
Total11 cases