Despite at least 25 years of overwhelming data from our research team and others against ....., the practice persists. There may be several reasons for this. One is that the risk is difficult to assess. To identify secondary neurologic injury, it is necessary to first document the neurologic status of the patient as a baseline to detect changes over time. In many cases, the precise neurologic status of the patient will not be known until extensive evaluation has been performed in the trauma center. Any deterioration that occurs before the baseline status will be difficult, if not impossible, to detect and is not likely to be associated with a particular mechanism.