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:

  • have a GCS score of 15 at 2 hours after the head injury and medium risk factors for intracranial bleeding or

  • 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

  • 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).