Marshall CT Classification (Traumatic Brain Injury)

Marshall CT classification for traumatic brain injury (Marshall 1991).

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

High/mixed-density mass lesion > 25 cc
None (diffuse injury — set the fields below)
Any visible intracranial pathology
Yes
Midline shift > 5 mm
Yes

Result: Marshall IV — Diffuse Injury IV (shift) — midline shift > 5 mm, no high/mixed-density mass lesion > 25 cc. Mortality highest of the diffuse categories.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Diffuse
Diffuse Injury I (no pathology); II (cisterns present, shift ≤ 5 mm, no mass > 25 cc); III (cisterns compressed/absent, shift ≤ 5 mm); IV (shift > 5 mm).
Mass lesion
Evacuated Mass Lesion (V) — lesion surgically evacuated; Non-evacuated Mass Lesion (VI) — mass > 25 cc, not evacuated. Mortality rises across categories; complements the additive Rotterdam score.

What you enter

  • High/mixed-density mass lesion > 25 cc
  • Any visible intracranial pathology (diffuse injury)
  • Basal cisterns compressed or absent
  • Midline shift > 5 mm
How this is calculated

Marshall LF, Marshall SB, Klauber MR, et al. A new classification of head injury based on computerized tomography. J Neurosurg. 1991;75(Suppl):S14-S20. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

Browse all tools

Built by Clay Good. Source on GitHub.