Head injury: assessment and early management

Evidence reviews - May 2023

The following documents contain the evidence that was used to develop the May 2023 recommendations:

• Tranexamic acid
• Transport to a distant specialist neuroscience centre
• Direct access from the community to imaging
• Clinical decision rules selecting people with head injury for imaging
• Selecting adults, children and infants with head injury for CT or MRI head scan in sub-groups
• Brain injury biomarkers and/or MRI for predicting post-concussion syndrome
• Brain injury biomarkers for predicting acute post-brain injury complications
• CT, MRI and X-ray of the cervical spine in people with head injury – diagnostic
• Admission and observation in hospital of people with head injury who are on anticoagulant or antiplatelet therapy after normal brain imaging or no indication for early imaging
• Admission and observation of people with concussion symptoms
• Hospital admission in people with small intracranial injuries
• Isolated skull fracture
• Identification of hypopituitarism (who to investigate)
• Identification of hypopituitarism (when to investigate)

Other supporting evidence:

• Economic analysis on the cost effectiveness of tranexamic acid

Evidence for all other recommendations can be found in the full guideline and supporting appendices:

• Full guideline
• Appendices