Table 2

Red flags for the risk of traumatic brain injury resulting in long-term neuropsychological impairments with an organic basis

Clinical feature	Risk of developing long-term neuropsychological sequelae	Comments
Intraventricular haemorrhage
Prolonged post-traumatic amnesia		High risk associated with PTA >1 week determined by prospective assessment*.
Surgical intervention required
Presence of ischaemic brain injury
Anoxia		Neuropsychological risk depends on the period and severity of anoxia.
Evidence of diffuse axonal injury on MRI		The more widespread the injury, the more widespread the associated cognitive deficit is likely to be.
Elevated ICP		The more elevated and longer the duration, the higher the risk.
Presence of midline shift
Evidence of inflammatory response
Evidence of sulcal effacement		Duration and extent is an important determinant of associated deficit.
Evidence of contusions		May result in focal deficits, particularly if damage remains evident on later neuroradiology (MRI).
Abnormalities suggestive of traumatic axonal injuries evident on DTI		May be associated with reduced processing speed or focal deficits. These abnormalities can also be present with no neuropsychological correlates.

Incomplete neuropsychological recovery likely.
Some long-term neuropsychological sequelae likely.
Possibility of some long.
Flags are cumulative.
*Reports of prolonged post-traumatic amnesia gained retrospectively must be carefully evaluated. If indicating significant brain trauma, there should also be an evident corroborative sign and symptoms.
DTI, diffusion tensor imaging; ICP, intracranial pressure; PTA, post-traumatic amnesia.