L'adozione della classificazione di Marshall in sei livelli ha consentito di trovare un “linguaggio comune” neuroradiologico nel valutare le TC eseguite dopo trauma cranico grave. Esistono però problemi concreti di applicazione che riguardano la inclusione del tipo di lesione, la presenza o meno di emorragia subaracnoidea post traumatica, il rapporto fra tipo di Danno Diffuso e prognosi e, soprattutto, il momento di esecuzione della TC. Viene inoltre definita la “TC peggiore” come quella che entro la prima settimana dopo trauma cranico grave mostra il maggior danno anatomico. Tale TC, e non quella di ingresso, si correla alla prognosi del paziente. Vengono forniti suggerimenti pratici riguardo al tempo di esecuzione dei controlli TC “precoci” (entro 24 ore dal trauma).
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