Abstract
A 35-year-old man was transferred comatose to a level-1 trauma center after being struck by a train. His vital signs were stable upon arrival. His physical examination revealed a Glasgow Coma Scale score of 3, extensive scalp laceration, and raccoon eyes, with normal findings for other systems. He was subsequently intubated, and computed tomography (CT) of the head and cervical spine as well as thorax and abdomen was performed.