{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:50:12Z","timestamp":1791345012477,"version":"4.3.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":88,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>Patients with mild traumatic brain injury (mTBI) presenting with intracranial hemorrhage (ICH) represent a heterogeneous group, with some experiencing clinical or radiologic deterioration despite initial stability. This study aimed to identify factors associated with clinically significant progression, defined as clinical or radiological worsening resulting in hospital admission or neurosurgical intervention, among patients with mTBI and ICH evaluated in the Emergency Department (ED) of Ramathibodi Hospital, Thailand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted of adult patients with mTBI (Glasgow Coma Scale [GCS] 13\u201315) and radiologically confirmed ICH who presented to the ED between 2019 and 2023. Data were retrieved from the hospital electronic medical record system. Patients managed conservatively with at least one repeated computed tomography (CT) scan were included in the study. Clinical and radiologic variables were analyzed using multivariable logistic regression to identify independent factors associated with progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 114 eligible patients, 26 (22.8%) demonstrated progression requiring hospital admission or neurosurgical intervention. Independent predictors of progression were midline shift (OR 11.58, 95% CI 2.93\u201345.78, p &lt; 0.001), systolic blood pressure \u2265160 mmHg (OR 5.49, 95% CI 1.69\u201317.77, p = 0.005), multiple ICH (OR 3.69, 95% CI 1.13\u201311.98, p = 0.030), and initial GCS 13\u201314 (OR 4.86, 95% CI 1.18\u201320.08, p = 0.029).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings may help guide decisions regarding closer observation and repeat CT brain imaging in patients at higher risk of progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12245-026-01290-2","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:22:54Z","timestamp":1783776174000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Progression of mild traumatic brain injury with intracranial hemorrhage: a retrospective study of associated factors in patients managed conservatively in the emergency department"],"prefix":"10.1186","volume":"19","author":[{"given":"Supapitch","family":"Chingthongkham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Welawat","family":"Tienpratarn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawarisa","family":"Thongpuntair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supitcha","family":"Chingthongkham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirote","family":"Wongwaisayawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"1290_CR1","unstructured":"Shukla D, Devi BI. 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Int J Environ Res Public Health. 2022;19(21):14311.","DOI":"10.3390\/ijerph192114311"},{"issue":"6","key":"1290_CR6","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.jemermed.2020.07.036","volume":"59","author":"EM Fiorelli","year":"2020","unstructured":"Galliazzo S, Bianchi MD, Virano A, Trucchi A, Donadini MP, Dentali F, et al. Intracranial bleeding risk after minor traumatic brain injury in patients on antithrombotic drugs. Thromb Res. 2019;174:113\u201320.","journal-title":"J Emerg Med"},{"key":"1290_CR7","doi-asserted-by":"crossref","unstructured":"Fiorelli EM, Bozzano V, Bonzi M, Rossi SV, Colombo G, Radici G, et al. Incremental risk of intracranial hemorrhage after mild traumatic brain injury in patients on antiplatelet therapy: systematic review and meta-analysis. 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Do we really need 24-h observation for patients with minimal brain injury and small intracranial bleeding? The Bernese Trauma Unit Protocol. Emerg Med J. 2010;27(7):537\u20139.","DOI":"10.1136\/emj.2009.073031"},{"key":"1290_CR11","doi-asserted-by":"crossref","unstructured":"Root BK, Kanter JH, Calnan DC, Reyes-Zaragosa M, Gill HS, Lanter PL. Emergency department observation of mild traumatic brain injury with minor radiographic findings: shorter stays, less expensive, and no increased risk compared to hospital admission. J Am Coll Emerg Physicians Open. 2020;1(4):609\u201317.","DOI":"10.1002\/emp2.12124"},{"issue":"7","key":"1290_CR12","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1136\/emj.2009.073031","volume":"27","author":"B Schaller","year":"2010","unstructured":"Vedin T, Svensson S, Edelhamre M, Karlsson M, Bergenheim M, Larsson PA. Management of mild traumatic brain injury: trauma energy level and medical history as possible predictors for intracranial hemorrhage. 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Acta Neurochir (Wien). 2022;164(1):97\u2013105.","journal-title":"Am J Emerg Med"}],"container-title":["International Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12245-026-01290-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-026-01290-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-026-01290-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:58:47Z","timestamp":1791341927000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12245-026-01290-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,11]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1290"],"URL":"https:\/\/doi.org\/10.1186\/s12245-026-01290-2","relation":{},"ISSN":["1865-1380"],"issn-type":[{"value":"1865-1380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,11]]},"assertion":[{"value":"13 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Human Research Ethics Committee, Faculty of Medicine Ramathibodi Hospital, Mahidol University (COA No. MURA2025\/13; January 6, 2025). The requirement for informed consent was waived due to the retrospective nature of the study and the use of anonymized data. All procedures were conducted in accordance with relevant ethical guidelines and regulations, including the Declaration of Helsinki and Good Clinical Practice (ICH-GCP). All personal identifiers were removed and replaced with study identification numbers prior to analysis.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this manuscript, the authors used ChatGPT and Grammarly for language editing and grammar checking. All content was reviewed and edited by the authors, who take full responsibility for the accuracy and integrity of the manuscript.","order":3,"name":"Ethics","label":"Use of artificial intelligence tools","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"260"}}