Volume 29, Issue 160, June 2025

Traumatic brain injury associated intracranial hemorrhage in the emergency department: Systematic review

Mazi Mohammed Alanazi^1♦, Wejdan Rubayyi S Alsaiari², Naser AlRashdan²

¹Saudi and Jordanian Board Emergency Medicine, Head of Emergency Research Unit, Emergency Department, First Health Cluster, Riyadh, Saudi Arabia
²Saudi board emergency medicine resident, Emergency Department, King Khalid University Hospital, Riyadh, Saudi Arabia

^♦Corresponding author
Mazi Mohammed Alanazi, Saudi and Jordanian Board Emergency Medicine, Head of Emergency Research Unit, Emergency Department, First Health Cluster, Riyadh, Saudi Arabia

ABSTRACT

Background: A frequent reason for emergency department (ED) visits is mild traumatic brain injury (mTBI). A traumatic intracranial hemorrhage (ICH) will occur in a small percentage of these individuals, and even fewer may experience serious consequences. To improve current ED recommendations, this systematic study was conducted to describe known and novel risk factors that affect the risk of ICH in patients with mTBI. Method: This systematic review was conducted in accordance with the PRISMA guidelines. The terms "risk factor," "mild traumatic brain injury," and "traumatic intracranial hemorrhage" were used to search the Web of Science, MEDLINE, Scopus, and EMBASE databases. The search was limited to articles released between 2018 and 2024. Research involving general ED populations with head trauma is included, as is research on adult patients (≥18 years) with mTBI, which is defined as GCS 13–15; patients presenting with suspected or confirmed ICH following head trauma. Result and conclusion: Variations in ICH risk factors, the involvement of drugs, and changing epidemiology continue to complicate the diagnosis and treatment of mTBI patients. The biggest predictors of ICH are post-traumatic amnesia, skull fractures, older age, and GCS <15. The most reliable diagnostic method is the CT scan; biomarkers and machine learning approaches may potentially reduce unnecessary scans.

Keywords: Traumatic brain injury, intracranial hemorrhage, emergency department

Medical Science, 2025, 29, e87ms3593

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DOI: https://doi.org/10.54905/disssi.v29i160.e87ms3593

Published: 18 June 2025