Which patients with mild TBI should have a noncontrast head CT scan in the ED?
• Is there a role for head magnetic resonance imaging (MRI) over noncontrast CT in the ED evaluation of a patient with acute mild TBI? • In patients with mild TBI, are brain-specific serum biomarkers predictive of an acute traumatic intracranial injury? • Can a patient with an isolated mild TBI and a normal neurologic evaluation result be safely discharged from the ED if a noncontrast head CT scan shows no evidence of intracranial injury? The 2002 document included a question regarding the role of plain film radiography in assessing mild TBI patients. This question was not included in this update, because there has been no new evidence regarding this subject. Thus the original recommendation remains unchanged: “Level B recommendation: Skull film radiographs are not recommended in the evaluation of mild TBI. Although the presence of a skull fracture increases the likelihood of an intracranial lesion, its sensitivity is not sufficient to be a useful screening test. Indeed, negative findi
