Safe Discharge of Patients with Small Traumatic Intracranial Bleeds

Patients with small post-traumatic intracranial bleeds are usually admitted for observation, and, in many such patients, neurological status does not deteriorate. To identify patients who can safely be discharged without observation, these authors retrospectively reviewed records of 1078 patients with minor head injuries who were admitted to an emergency department in Switzerland for 24 hours of neurosurgical observation during a 2-year period. Exclusion criteria were multiple intracranial bleeds, bleeds >5 mm, known coagulopathy, treatment with anticoagulants or platelet aggregation inhibitors, intoxication, multiple injuries, no one to observe the patient at home, and home >1 hour from the hospital.

Overall, 110 patients presented with iso…