Combined intracranial hemorrhage subtypes should not change modified Brain Injury Guidelines criteria

The Journal of Trauma: Injury, Infection, and Critical Care 2026

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Authors: Emily Johnson, Janet S. Lee, Michael William Cripps, Robert C. McIntyre, Thomas J. Schroeppel
DOI: 10.1097/ta.0000000000004864
Cited by: 0
References: 20

Abstract

BACKGROUND: The modified Brain Injury Guidelines (mBIG) are an established protocol to triage traumatic brain injury with intracranial hemorrhage (ICH) while reducing resource utilization. However, mBIG do not differentiate between isolated and combined intracranial hemorrhage (cICH). This study evaluated whether patients with multiple ICH subtypes require different triage. METHODS: We performed a retrospective study of adult patients classified as mBIG 1 or mBIG 2 at two Level I trauma centers January 1, 2017, to June 30, 2023. Patients with cICH (≥2 subtypes) were compared with isolated ICH. Primary outcome was clinical deterioration, defined as new focal neurologic findings, pupillary examination changes or Glasgow Coma Scale score of

Fields of Study & Subjects

Traumatic Brain Injury and Neurovascular Disturbances Trauma and Emergency Care Studies Traumatic Brain Injury Research

Publication details

Journal / source
The Journal of Trauma: Injury, Infection, and Critical Care
Volume
100
Issue
3
Pages
393–397
Publication date
4 February 2026
Language
EN