Some Patients with Isolated Traumatic Intracranial Hemorrhage May Not Need Neurosurgical Evaluation

Current practice for patients with isolated traumatic intracranial hemorrhage includes emergent neurosurgical evaluation and transfer to a trauma center, yet few patients end up needing any intervention. These authors assessed predictors of clinical deterioration requiring intervention or neurosurgical evaluation in a retrospective cross-sectional study of 404 adult patients who presented to a single trauma center with traumatic intracranial hemorrhage, isolated blunt head injury, and Glasgow Coma Scale (GCS) scores ≥13.

Forty-eight patients (11.8%) experienced clinical deterioration, defined as decrease in mental status, worsening neurologic examination result, death, worsening repeat computed tomography scan result, or need for surgery dur…