CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF MILD HEAD INJURY (MHI) IN ADULTS

- Research Gaps

During the review of evidence and development of recommendations, several research gaps were identified:

(1) Anticoagulated/antiplatelet patients: Clear risk stratification for CT, observation, admission, and repeat CT (especially DOACs vs warfarin).

(2) Delayed intracranial hemorrhage: Optimal duration of observation after a normal initial CT remains uncertain.

(3) Older adults: Need tailored pathways for elderly/frail patients, including those with baseline cognitive impairment or recurrent falls.

(4) Intoxicated patients: Insufficient data on safe imaging and discharge decisions when clinical assessment is unreliable.

(5) Low-resource settings: Lack of evidence on effective CT-unavailable pathways, referral thresholds, and cost-effectiveness.

(6) Patient-centered outcomes: Limited data on long-term outcomes (missed injuries, post-concussion symptoms, re-attendance, satisfaction).