- CT scan reveals traumatic intracranial abnormalities in fewer than 10% of patients following mild traumatic brain injury (mTBI). Management policy in these patients is not clear.
- Clinical or radiological deterioration occurs in 10-20% of this risk group, usually within 24 hours and often without neurosurgical consequences.
- Patients with mTBI and subarachnoid blood or small foci of contusion do not need to be admitted to medium/high care or to the ICU. This is warranted in patients fulfilling the following criteria: age > 65 years; a Glasgow Coma Scale (GCS) score < 15; anticoagulant use; or multiple trauma. It is also warranted by fulfilment of one or more of the following CT-criteria: shift of the midline; subdural or epidural haematoma; a temporal or subfrontal focus of contusion; or intraparenchymatous bleeding > 10 ml.
- Repeated CT-scan is only indicated in case of clinical deterioration. Transfer to a neurosurgical centre is not necessary in the majority of patients with mTBI and CT abnormalities.
Conflict of interest and financial support: none declared.