Guidance
Recommendations for research
Recommendations for research
The guideline committee has made these recommendations for research.
Key recommendations for research
1 Indications for admission in people with a mild head injury and a confirmed abnormality on a CT scan
What are the indications for admission using clinical decision rules in people with a Glasgow Coma Scale (GCS) score of 13 to 15 (a mild head injury) and a confirmed abnormality on a CT scan? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on admission and observation .
Full details of the evidence and the committee's discussion are in evidence review K: hospital admission in people with small intracranial injuries.
2 Using biomarkers for predicting acute post-traumatic brain injury complications
What is the diagnostic accuracy of brain injury biomarkers for predicting acute complications after a traumatic brain injury? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on post-concussion syndrome .
Full details of the evidence and the committee's discussion are in evidence review G: brain injury biomarkers for predicting acute post-brain injury complications.
3 Indications for imaging for people with a history of recurrent head injuries
What is the risk of intracranial injuries in people with a history of recurrent head injuries, including from sports and falls, and no other indications for a CT scan? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on criteria for doing a CT head scan .
Full details of the evidence and the committee's discussion are in evidence review E: selecting adults, children and infants with head injury for CT or MRI head scan in sub-groups.
4 Risk of bleeding for people with a pre-injury coagulopathy
What is the risk of any intracranial bleeding or intracranial bleeding associated with clinical deterioration after head injury in people with a pre-injury coagulopathy? This includes medical conditions such as liver failure or haemophilia, or taking anticoagulants or antiplatelets in people who:
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have a GCS score of 15 at 2 hours after the head injury and medium risk factors for intracranial bleeding or
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loss of consciousness or amnesia with no additional risk factors (that is, they are under 65, had a low-energy transfer injury and any retrograde amnesia has lasted for less than 30 minutes) or
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there is no loss of consciousness or amnesia [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on criteria for doing a CT head scan .
Full details of the evidence and the committee's discussion are in evidence review E: selecting adults, children and infants with head injury for CT or MRI head scan in sub-groups.
5 Indications for imaging for people with a pre-injury cognitive impairment
What are the indications for selecting imaging in adults, young people, children and babies with a head injury sustained through a low-energy fall and with suspected pre-injury cognitive impairment when loss of consciousness or amnesia is difficult to assess or the pre-injury GCS score is not 15? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on criteria for doing a CT head scan .
Full details of the evidence and the committee's discussion are in evidence review E: selecting adults, children and infants with head injury for CT or MRI head scan in sub-groups.
Other recommendations for research
6 Transport to a neuroscience centre
What is the clinical and cost effectiveness of pre-hospital strategies to take people with a head injury to a distant specialist neuroscience centre instead of a closer non-specialist unit? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on transport to hospital .
Full details of the evidence and the committee's discussion are in evidence review B: transfer to a distant specialist neuroscience centre.
7 Tranexamic acid
What is the clinical and cost effectiveness of tranexamic acid before imaging in people presenting within 2 hours of a head injury with a GCS score of 13 to 15 and high-risk indications for intracranial bleeding? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on tranexamic acid .
Full details of the evidence and the committee's discussion are in evidence review A: tranexamic acid.
8 Indications for selecting people for imaging when they present more than 24 hours after a head injury
What are the indications for selecting people of any age who present more than 24 hours after a head injury for a CT or MRI head scan? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on criteria for doing a CT head scan .
Full details of the evidence and the committee's discussion are in evidence review E: selecting adults, children and infants with head injury for CT or MRI head scan in sub-groups.
9 Using biomarkers and MRI for predicting post-concussion syndrome
What is the prognostic accuracy of brain injury biomarkers or MRI for predicting post-concussion syndrome? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on post-concussion syndrome .
Full details of the evidence and the committee's discussion are in evidence review F: brain injury biomarkers and/or MRI for predicting post-concussion syndrome.
10 Timing of testing for hypopituitarism
When should people with a head injury be investigated for hypopituitarism? [2023]
For a short explanation of why the committee made this recommendation for research, see the rationale section on early diagnosis of hypopituitarism .
Full details of the evidence and the committee's discussion are in evidence review N: identification of hypopituitarism (when to investigate).