Both Marshal and Rotterdam grading systems are good in predicting early mortality after moderate and severe TBI. As the Rotterdam system also includes additional variables like subarachnoid hemorrhage, it may be preferable, particularly in patients with diffuse injury.

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Aim: To establish the correlation between initial GCS score and its impact on further management and outcome. Materials And Methods: A prospective study was done at department of surgery at Jmch from April 2021 to march 2022 on 30 patients after fulfilling inclusion and exclusion criteria. Data was collected using patient data sheets which were presented in tables and graph. Results: Out of 30 cases,23 males and 7 females were observed out of which maximum incidence observed at the age of 21 to 30 years with RTA being most common mode of injury. 17 patients were observed with gcs>13 of which 13 patients underwent conservative management. At the end of study all patients discharged with good outcome. Conclusions: Study shows incidence of EDH in MF about 2.74: 1.This study examined the factor for surgery from the clinical rather than radiologic perspective of initial EDH, which is not indicated for GCS score can be a factor for deciding the further management of EDH.