Clinical significance of posttraumatic intracranial hemorrhage in clinically mild brain injury: a retrospective cohort study

Article Figures & Tables

Table 1:

Baseline characteristics of patients with mild traumatic brain injury and computed tomography findings of intracranial hemorrhage

Characteristic	No. (%) of patients^* n = 607
Median age, yr (IQR)	55 (37–70)
Male	415 (68.4)
Mechanism of injury
Fall	234 (38.6)
Motor vehicle collision	138 (22.7)
Struck by motor vehicle as pedestrian	111 (18.3)
Struck by motor vehicle as cyclist	44 (7.2)
Assault (blunt trauma)	23 (3.8)
Motorcycle/all-terrain vehicle collision	23 (3.8)
Other^†	34 (5.6)
Isolated head injury	57 (9.4)
Finding on initial head CT
Traumatic subarachnoid hemorrhage	325 (53.5)
Subdural hematoma	280 (46.1)
Intracerebral hemorrhage	218 (35.9)
Skull fracture/pneumocephalus	124 (20.4)
Intraventricular hemorrhage	48 (7.9)
Epidural hematoma	36 (5.9)
Concomitant other injuries
Face + neck	281 (46.3)
Thorax	240 (39.5)
Abdomen/pelvis	61 (10.0)
Spine	186 (30.6)
Upper extremity	212 (34.9)
Lower extremity	167 (27.5)
External/burns/other	19 (3.1)
Median Injury Severity Score (IQR)	17 (14–24)
Total Injury Severity Score
1–15	197 (32.4)
16–25	274 (45.1)
> 25	133 (21.9)
Missing	3 (0.5)
Initial Glasgow Coma Scale score
15	374 (61.6)
14	185 (30.5)
13	48 (7.9)
Alcohol consumption (n = 392)
No	316 (80.6)
Yes, beyond legal limit	60 (15.3)
Yes, trace limit	16 (4.1)

Note: CT = computed tomography, IQR = interquartile range.
↵* Except where noted otherwise.
↵† Intentional self-harm, snowmobile accident, diving injury, watercraft-related injury.

Table 2:

Hospital course, imaging and interventions

Variable	No. (%) of patients^*
No. of head CT scans, median (IQR)	2 (2–3)
No. of head CT scans
1	101 (16.6)
2	304 (50.1)
3	118 (19.4)
≥ 4	84 (13.8)
Indication for repeat head CT (n = 506)
Routine^†	385 (76.1)
Neurologic deterioration	30 (5.9)
Rule out vascular injury	89 (17.6)
Other	2 (0.4)
Finding on repeat head CT altered medical management^‡	7 (1.4)
Disposition after emergency department
Trauma/general surgery	282 (46.5)
Neurosurgery	160 (26.4)
Medicine	78 (12.8)
Orthopedic surgery	51 (8.4)
Plastic surgery	7 (1.2)
Discharged	29 (4.8)
Length of stay, d, median (IQR)	7 (3–13.25)
Total length of stay, d
≤ 7	317 (52.2)
8–14	156 (25.7)
> 14	134 (22.1)
Required ICU stay	382 (62.9)
Length of ICU stay, d, median (IQR)	3 (1–6)
Total length of ICU stay, d (n = 382)
≤ 7	307 (80.4)
8–14	39 (10.2)
> 14	36 (9.4)
Required neurosurgical intervention^§	5 (0.8)
Type of operation (n = 5)
Decompressive craniectomy	3 (60)
Craniotomy	2 (40)

Note: CT = computed tomography, ICU = intensive care unit, IQR = interquartile range.
↵* Except where noted otherwise.
↵† Done in the absence of any documented neurologic change.
↵‡ E.g., extended length of stay, administration of antiplatelets for vascular dissection.
↵§ Owing to clinical deterioration within 72 hours in all cases.