Patients with severe head trauma who talk and deteriorate

Walk and Die: An Unusual Presentation of Head Injury

“…The terms “talk and deteriorate” and “talk and die” have been applied in medical literature to describe patients who suffer from mild to moderate head injury, are able to articulate recognizable words, and then deteriorate within 48 h of the injury (1–4). In a review of cases over a 10‐year period, Goldschlager et al.…”

“…The terms ''talk and deteriorate'' and ''talk and die'' have been applied in medical literature to describe patients who suffer from mild to moderate head injury, are able to articulate recognizable words, and then deteriorate within 48 h of the injury (1)(2)(3)(4). In a review of cases over a 10-year period, Goldschlager et al documented six such cases in which the predominant pathology was cerebral contusions, peri-contusional edema, progressive generalized swelling, and cisternal effacement, but none in which there was isolated diffuse brain swelling (3).…”

“…Invariably, these deaths are associated with the onset of unconsciousness during the assault: most never recover consciousness, but some may do so, only then to deteriorate and die after a lucid interval which is at least 20–30 min and more usually several hours. This so‐called “talk and die” or “talk and deteriorate” scenario is almost always associated with the development of an intracranial hematoma—i.e., they have an easily identifiable intracranial cause to explain their deterioration and deaths (1–4).…”