Abstract
The Glasgow Coma Scale has remained the principal clinical descriptor of traumatic brain injury for five decades [1], and management thresholds in current guidelines are anchored to the admission score [2]. Far less attention is paid to how the score changes over the following days, although the rate at which consciousness returns reflects the reversibility of the secondary injury cascade rather than the extent of the primary lesion [3]. In open injury, where the dura is breached and the wound tract is contaminated, the early course may differ from that of closed injury, but serial data are scarce.
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