A 30-year-old woman was unconscious after falling from stairs. What is a likely diagnosis if she later becomes unresponsive with a GCS of 6?

In the context of a traumatic brain injury, the presentation of a 30-year-old woman who was initially unconscious after a fall and later becomes unresponsive with a Glasgow Coma Scale (GCS) of 6 suggests a serious condition related to significant intracranial bleeding. An epidural hematoma is characterized by a lucid interval—initial loss of consciousness followed by a temporary period of alertness—before a rapid decline in consciousness ensues, often leading to marked neurological deficits.

The mechanism of injury, typically involving a blow to the head that results in a tear of an artery (often the middle meningeal artery), causes blood to accumulate between the dura mater and the skull, which creates increased intracranial pressure. The acute deterioration in the neurologic status, indicated by a low GCS, aligns with this diagnosis. In the case of an epidural hematoma, the clinical evolution often follows this pattern of deterioration.

While other options, such as subdural hematoma or contusion, might also potentially present with loss of consciousness, they differ in their typical clinical progression and mechanisms. Subdural hematomas might present more subtly and are associated with venous bleeding, while contusions involve bruising of the brain tissue without the specific