Inclusion Criteria:  Age 15 or older Admission CT Scan shows intracranial hemorrhage Glasgow Coma Scale less than 15 Neurosurgery service determines initial care is nonoperative Admitted for observation for TBI, to either step-down unit or intensive care unit  Exclusion Criteria:  Inability to provide informed consent or lack of a legally authorized representative (LAR) Admitted and observed for >2 hours prior to screening (i.e., has already received second neurological check) Other injuries deemed non-survivable Diagnosed with hemorrhagic shock or receives a large volume transfusion (>3 units of any blood product within any 1 hour) Planned surgical interventions/ procedures during study period (before the second CT scan) Known prisoner