{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:20:02Z","timestamp":1781666402034,"version":"3.54.5"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Emerg Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the diagnostic yield of cranial computed tomography (CT) imaging in patients who sustained minor head trauma after directly hitting their head on a shelf or cupboard, without an associated fall. The study aimed to assess whether such low-impact mechanisms warrant cranial imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective observational study conducted at the emergency department of a major trauma centre in the United Kingdom. Data were extracted from the institutional Radiology Information System and electronic health records, covering the period from June 2006 to April 2025. An initial cohort of 320 patients referred for CT head imaging was identified using a keyword-based search of radiology request histories. Of these, 109 patients were included based on a clearly documented mechanism of injury involving impact with a cupboard or shelf, without an associated fall. Exclusion criteria included alternative mechanisms such as falls, falling objects, assault, or irrelevant mentions. The primary outcome was the presence of acute intracranial pathology on CT head. Secondary data collected included age, sex, injury mechanism, clinical symptoms, adherence to National Institute for Health and Care Excellence (NICE) head injury imaging criteria, and any scalp or skull findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 109 included patients, median age was 48 (31\u201366), females 76 (70%). Eight patients (7%) had scalp findings, including swelling or laceration. Despite the low-force mechanism, 79 patients (72%) met at least one NICE guideline criterion for imaging, most commonly due to vomiting or anticoagulant use. None demonstrated acute intracranial pathology or skull fracture on the CT head scan. The absence of positive findings suggests that careful vetting of NICE criteria in the context of biomechanically implausible mechanisms may reduce unnecessary imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Walking into or standing up and hitting a shelf or cupboard is an insufficient force to generate clinically significant traumatic brain injury. Direct head impact from a fixed object, without an associated fall, appears to be a biomechanically low-risk mechanism. This study supports a more scrutinised and context-aware application of the NICE head injury criteria in such scenarios, to help rationalise imaging demand, optimise resource use, and reduce unnecessary exposure to ionising radiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10140-025-02430-6","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T07:09:07Z","timestamp":1768460947000},"page":"203-208","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Shelf-inflicted head injuries"],"prefix":"10.1007","volume":"33","author":[{"given":"Nitin","family":"Menon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9523-2546","authenticated-orcid":false,"given":"Rob A.","family":"Dineen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"2430_CR1","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1136\/archdischild-2015-308424","volume":"101","author":"L Trefan","year":"2016","unstructured":"Trefan L, Houston R, Pearson G et al (2016) Epidemiology of children with head injury: a national overview. Arch Dis Child 101:527\u2013532. https:\/\/doi.org\/10.1136\/archdischild-2015-308424","journal-title":"Arch Dis Child"},{"key":"2430_CR2","unstructured":"(2023) Overview | Head injury: assessment and early management | Guidance | NICE. https:\/\/www.nice.org.uk\/guidance\/ng232. Accessed 26 July 2025"},{"key":"2430_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2016.08.032","author":"E Klang","year":"2017","unstructured":"Klang E, Beytelman A, Greenberg D et al (2017) Overuse of head CT examinations for the investigation of minor head trauma: analysis of contributing factors. J Am Coll Radiol. https:\/\/doi.org\/10.1016\/j.jacr.2016.08.032","journal-title":"J Am Coll Radiol"},{"key":"2430_CR4","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1016\/j.crad.2022.06.023","volume":"77","author":"PC Lyon","year":"2022","unstructured":"Lyon PC, Murchison AG, Chen M et al (2022) A bump in the night: a 15-year retrospective analysis of urgent inpatient and emergency CT reporting out of hours in a tertiary referral centre. Clin Radiol 77:810\u2013822. https:\/\/doi.org\/10.1016\/j.crad.2022.06.023","journal-title":"Clin Radiol"},{"key":"2430_CR5","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1056\/NEJMra072149","volume":"357","author":"DJ Brenner","year":"2007","unstructured":"Brenner DJ, Hall EJ (2007) Computed tomography \u2014 an increasing source of radiation exposure. N Engl J Med 357:2277\u20132284. https:\/\/doi.org\/10.1056\/NEJMra072149","journal-title":"N Engl J Med"},{"key":"2430_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2017.05.009","author":"D Remedios","year":"2017","unstructured":"Remedios D, France B, Alexander M (2017) Making the best value of clinical radiology: iRefer guidelines, 8th edition. Clin Radiol. https:\/\/doi.org\/10.1016\/j.crad.2017.05.009","journal-title":"Clin Radiol"},{"key":"2430_CR7","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1177\/1460408612446573","volume":"14","author":"A Post","year":"2012","unstructured":"Post A, Hoshizaki TB (2012) Mechanisms of brain impact injuries and their prediction: a review. Trauma 14:327\u2013349. https:\/\/doi.org\/10.1177\/1460408612446573","journal-title":"Trauma"},{"key":"2430_CR8","unstructured":"Menon N, Hutchinson R, Dineen RA (2025) Shelf-inflicted head injury: a review of cranial CT yield in minor head bumps [protocol and analysis plan]. University of Nottingham, Faculty of Medicine and Health Sciences, Sir Peter Mansfield Imaging Centre, Nottingham, UK"},{"key":"2430_CR9","unstructured":"Health Research Authority defining research table. Health Research Authority"},{"key":"2430_CR10","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2021.2016929","author":"G Tierney","year":"2024","unstructured":"Tierney G (2024) Concussion biomechanics, head acceleration exposure and brain injury criteria in sport: a review. Sports Biomech. https:\/\/doi.org\/10.1080\/14763141.2021.2016929","journal-title":"Sports Biomech"},{"key":"2430_CR11","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.1148\/rg.2019190076","volume":"39","author":"AD Schweitzer","year":"2019","unstructured":"Schweitzer AD, Niogi SN, Whitlow CT, Tsiouris AJ (2019) Traumatic brain injury: imaging patterns and complications. Radiographics 39:1571\u20131595. https:\/\/doi.org\/10.1148\/rg.2019190076","journal-title":"Radiographics"},{"key":"2430_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2024.111536","author":"RM Kwee","year":"2024","unstructured":"Kwee RM, Toxopeus R, Kwee TC (2024) Imaging overuse in the emergency department: the view of radiologists and emergency physicians. Eur J Radiol. https:\/\/doi.org\/10.1016\/j.ejrad.2024.111536","journal-title":"Eur J Radiol"},{"key":"2430_CR13","unstructured":"Royal College of Radiologists (2024) Clinical Radiology Workforce Census 2024. https:\/\/www.rcr.ac.uk\/media\/4imb5jge\/_rcr-2024-clinical-radiology-workforce-census-report.pdf. Accessed 11 Dec 2025"},{"key":"2430_CR14","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.jacr.2016.09.018","volume":"14","author":"TN Hanna","year":"2017","unstructured":"Hanna TN, Shekhani H, Lamoureux C et al (2017) Emergency radiology practice patterns: shifts, schedules, and job satisfaction. J Am Coll Radiol 14:345\u2013352. https:\/\/doi.org\/10.1016\/j.jacr.2016.09.018","journal-title":"J Am Coll Radiol"},{"key":"2430_CR15","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.jacr.2015.11.003","volume":"13","author":"JA Harolds","year":"2016","unstructured":"Harolds JA, Parikh JR, Bluth EI et al (2016) Burnout of radiologists: frequency, risk factors, and remedies: a report of the ACR commission on human resources. J Am Coll Radiol 13:411\u2013416. https:\/\/doi.org\/10.1016\/j.jacr.2015.11.003","journal-title":"J Am Coll Radiol"}],"container-title":["Emergency Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-025-02430-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10140-025-02430-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-025-02430-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:45:53Z","timestamp":1781628353000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10140-025-02430-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["2430"],"URL":"https:\/\/doi.org\/10.1007\/s10140-025-02430-6","relation":{},"ISSN":["1438-1435"],"issn-type":[{"value":"1438-1435","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]},"assertion":[{"value":"1 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}