{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:27:47Z","timestamp":1785515267157,"version":"3.56.0"},"reference-count":82,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The Brain Injury Guidelines (BIG) were modified in 2020 to improve efficiency and safety in triage decision-making. The aim of this study was to present characteristics and in-hospital outcomes of patients classified under category 1 of the modified BIG (mBIG 1).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A retrospective review of patients presenting with acute traumatic brain injury (TBI) to a level 1 trauma center between 2019 and 2023 was performed. Patients meeting clinical and radiographic criteria for mBIG 1 were identified. An additional cohort of patients was identified who were taking 81 mg of aspirin once daily (ASA81) before the hospital, but who otherwise met mBIG 1 criteria. Summary statistics and univariate analyses were performed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Three hundred three patients were identified and classified as mBIG 1. The mean patient age was 54.45 (SD 1.17) years and 41.3% were female. There were 144 patients (47.5%) who transferred from an outside hospital. The median admission Glasgow Coma Scale score was 15 (interquartile range [IQR] 15\u201315). Patients underwent an average of 2.28 (SD 0.03) CT scans. There were 123 (40.6%), 18 (5.9%), and 126 (41.6%) patients with subdural hematoma, intraparenchymal hemorrhage, and subarachnoid hemorrhage, respectively, with 36 patients (11.9%) presenting with multiple hemorrhages. Eleven patients (3.6%) experienced hemorrhage progression. No patient underwent neurosurgical intervention. The mean Injury Severity Score was 13.12 (SD 7.04). The median hospital length of stay (LOS) was 1.01 (IQR 0.37\u20134.56) days, 75.2% of patients were discharged home, 24.1% were discharged to rehabilitation, and 0.7% died in the hospital. An additional 25 patients were identified who were taking ASA81 prehospital, but otherwise met mBIG 1 criteria. None of these patients underwent neurosurgical intervention and there were no in-hospital deaths. One patient (4.0%) taking ASA81 experienced progression of their hemorrhage but still met mBIG 1 criteria. When compared to the mBIG 1 cohort, the aspirin cohort was significantly older (p < 0.001), but otherwise showed no differences in demographic, clinical, or radiographic variables. The combined mBIG 1 + aspirin cohort was stratified by hemorrhage progression (n = 12). Hospital LOS was significantly greater in the progression cohort (p = 0.017) and fewer patients were discharged home (p = 0.001). There was no difference in age, hypertension, admission mean arterial pressure, platelet count, international normalized ratio, partial thromboplastin time, hemorrhage pattern, and aspirin use between the groups.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Hemorrhage progression was rare, including cases in which patients were receiving prehospital low-dose aspirin therapy. More data are needed that evaluate the role of low-dose aspirin in the triage of patients with mild TBI.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.6.jns25342","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:39:10Z","timestamp":1760146750000},"page":"104-111","source":"Crossref","is-referenced-by-count":3,"title":["Characteristics and in-hospital outcomes of patients presenting to a level 1 trauma center classified under the modified Brain Injury Guidelines"],"prefix":"10.3171","volume":"144","author":[{"given":"Kevin T.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K.","family":"Yarmoska","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Lomangino","sequence":"additional","affiliation":[{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Callum D.","family":"Dewar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hentschel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Scarboro","sequence":"additional","affiliation":[{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Aresco","sequence":"additional","affiliation":[{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah M.","family":"Stein","sequence":"additional","affiliation":[{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Efron","sequence":"additional","affiliation":[{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Schwartzbauer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore;"},{"name":"Program in Trauma, R. Adams Cowley Shock Trauma Center, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation","article-title":"Centers for Disease Control and Prevention","year":"2014","unstructured":"Centers for Disease Control and Prevention. Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation. National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention; 2014."},{"issue":"2","key":"b2","series-title":"J Neurosurg","first-page":"584","article-title":"Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases","volume":"135","author":"Stopa BM","year":"2021","unstructured":"Stopa BM, Harary M, Jhun R, Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases. J Neurosurg. 2021;135(2):584\u2013593."},{"issue":"12","key":"b3","series-title":"JAMA","first-page":"1515","article-title":"National inventory of hospital trauma centers","volume":"289","author":"MacKenzie EJ","year":"2003","unstructured":"MacKenzie EJ, Hoyt DB, Sacra JC, National inventory of hospital trauma centers. JAMA. 2003;289(12):1515\u20131522."},{"issue":"4","key":"b4","series-title":"J Trauma Acute Care Surg","first-page":"965","article-title":"The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons","volume":"76","author":"Joseph B","year":"2014","unstructured":"Joseph B, Friese RS, Sadoun M, The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons. J Trauma Acute Care Surg. 2014;76(4):965\u2013969."},{"issue":"2","key":"b5","series-title":"J Trauma Acute Care Surg","first-page":"157","article-title":"Validating the Brain Injury Guidelines: results of an American Association for the Surgery of Trauma prospective multi-institutional trial","volume":"93","author":"Joseph B","year":"2022","unstructured":"Joseph B, Obaid O, Dultz L, Validating the Brain Injury Guidelines: results of an American Association for the Surgery of Trauma prospective multi-institutional trial. J Trauma Acute Care Surg. 2022;93(2):157\u2013165."},{"issue":"1","key":"b6","series-title":"Trauma Surg Acute Care Open","first-page":"e000483","article-title":"Multicenter assessment of the Brain Injury Guidelines and a proposal of guideline modifications","volume":"5","author":"Khan AD","year":"2020","unstructured":"Khan AD, Elseth AJ, Brosius JA, Multicenter assessment of the Brain Injury Guidelines and a proposal of guideline modifications. Trauma Surg Acute Care Open. 2020;5(1):e000483."},{"issue":"4","key":"b7","series-title":"J Neurosurg","first-page":"661","article-title":"Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study","volume":"99","author":"Spektor S","year":"2003","unstructured":"Spektor S, Agus S, Merkin V, Constantini S. Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study. J Neurosurg. 2003;99(4):661\u2013665."},{"issue":"1","key":"b8","series-title":"J Surg Res","first-page":"287","article-title":"Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: a prospective study","volume":"186","author":"Joseph B","year":"2014","unstructured":"Joseph B, Aziz H, Pandit V, Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: a prospective study. J Surg Res. 2014;186(1):287\u2013291."},{"issue":"4","key":"b9","series-title":"Circulation","first-page":"e65","article-title":"Forecasting the burden of cardiovascular disease and stroke in the United States through 2050\u2014prevalence of risk factors and disease: a presidential advisory from the American Heart Association","volume":"150","author":"Joynt Maddox KE","year":"2024","unstructured":"Joynt Maddox KE, Elkind MSV, Aparicio HJ, Forecasting the burden of cardiovascular disease and stroke in the United States through 2050\u2014prevalence of risk factors and disease: a presidential advisory from the American Heart Association. Circulation. 2024;150(4):e65\u2013e88."},{"issue":"7872","key":"b10","series-title":"Lancet","first-page":"81","article-title":"Assessment of coma and impaired consciousness. A practical scale","volume":"2","author":"Teasdale G","year":"1974","unstructured":"Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81\u201384."},{"issue":"1","key":"b11","series-title":"J Trauma Acute Care Surg","first-page":"106","article-title":"A multicenter validation of the modified brain injury guidelines: are they safe and effective?","volume":"93","author":"Khan AD","year":"2022","unstructured":"Khan AD, Lee J, Galicia K, A multicenter validation of the modified brain injury guidelines: are they safe and effective? J Trauma Acute Care Surg. 2022;93(1):106\u2013112."},{"issue":"3","key":"b12","series-title":"J Trauma","first-page":"187","article-title":"The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care","volume":"14","author":"Baker SP","year":"1974","unstructured":"Baker SP, O\u2019Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187\u2013196."},{"issue":"1","key":"b13","series-title":"Injury","first-page":"109","article-title":"Defining major trauma using the 2008 Abbreviated Injury Scale","volume":"47","author":"Palmer CS","year":"2016","unstructured":"Palmer CS, Gabbe BJ, Cameron PA. Defining major trauma using the 2008 Abbreviated Injury Scale. Injury. 2016;47(1):109\u2013115."},{"issue":"4","key":"b14","series-title":"Ann Pharmacother","first-page":"323","article-title":"Increased enoxaparin dosing for venous thromboembolism prophylaxis in general trauma patients","volume":"51","author":"Walker CK","year":"2017","unstructured":"Walker CK, Sandmann EA, Horyna TJ, Gales MA. Increased enoxaparin dosing for venous thromboembolism prophylaxis in general trauma patients. Ann Pharmacother. 2017;51(4):323\u2013331."},{"issue":"2","key":"b15","series-title":"Intern Emerg Med","first-page":"523","article-title":"In old anticoagulated patients with mild traumatic brain injury, a 24-h observation period should not be recommended without evidence of a clear benefit: a retrospective study of delayed hemorrhagic versus iatrogenic complications","volume":"19","author":"Benedetti S","year":"2024","unstructured":"Benedetti S, Benedetti MD, Tomasi D, In old anticoagulated patients with mild traumatic brain injury, a 24-h observation period should not be recommended without evidence of a clear benefit: a retrospective study of delayed hemorrhagic versus iatrogenic complications. Intern Emerg Med. 2024;19(2):523\u2013534."},{"issue":"1","key":"b16","series-title":"J Trauma","first-page":"E1","article-title":"Incidence and predictors of intracranial hemorrhage after minor head trauma in patients taking anticoagulant and antiplatelet medication","volume":"70","author":"Brewer ES","year":"2011","unstructured":"Brewer ES, Reznikov B, Liberman RF, Incidence and predictors of intracranial hemorrhage after minor head trauma in patients taking anticoagulant and antiplatelet medication. J Trauma. 2011;70(1):E1\u2013E5."},{"issue":"1","key":"b17","series-title":"Scand J Trauma Resusc Emerg Med","first-page":"123","article-title":"Incidence of delayed bleeding in patients on antiplatelet therapy after mild traumatic brain injury: a systematic review and meta-analysis","volume":"29","author":"Colombo G","year":"2021","unstructured":"Colombo G, Bonzi M, Fiorelli E, Incidence of delayed bleeding in patients on antiplatelet therapy after mild traumatic brain injury: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2021;29(1):123."},{"issue":"4","key":"b18","series-title":"J Trauma","first-page":"668","article-title":"Intracranial complications of preinjury anticoagulation in trauma patients with head injury","volume":"53","author":"Mina AA","year":"2002","unstructured":"Mina AA, Knipfer JF, Park DY, Bair HA, Howells GA, Bendick PJ. Intracranial complications of preinjury anticoagulation in trauma patients with head injury. J Trauma. 2002;53(4):668\u2013672."},{"issue":"7","key":"b19","series-title":"Intern Emerg Med","first-page":"1077","article-title":"Intracranial hemorrhage in anticoagulated patients with mild traumatic brain injury: significant differences between direct oral anticoagulants and vitamin K antagonists","volume":"13","author":"Cipriano A","year":"2018","unstructured":"Cipriano A, Pecori A, Bionda AE, Intracranial hemorrhage in anticoagulated patients with mild traumatic brain injury: significant differences between direct oral anticoagulants and vitamin K antagonists. Intern Emerg Med. 2018;13(7):1077\u20131087."},{"issue":"4","key":"b20","series-title":"Neurol Clin Pract","first-page":"296","article-title":"Mild brain injury and anticoagulants: Less is enough","volume":"7","author":"Campiglio L","year":"2017","unstructured":"Campiglio L, Bianchi F, Cattalini C, Mild brain injury and anticoagulants: Less is enough. 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J Emerg Med. 2016;51(5):519\u2013528."},{"issue":"3","key":"b23","series-title":"J Trauma","first-page":"553","article-title":"Traumatic brain injury in anticoagulated patients","volume":"60","author":"Cohen DB","year":"2006","unstructured":"Cohen DB, Rinker C, Wilberger JE. Traumatic brain injury in anticoagulated patients. J Trauma. 2006;60(3):553\u2013557."},{"issue":"1","key":"b24","series-title":"Am Surg","first-page":"43","article-title":"Repeat head computed tomography in anticoagulated traumatic brain injury patients: still warranted","volume":"80","author":"Joseph B","year":"2014","unstructured":"Joseph B, Sadoun M, Aziz H, Repeat head computed tomography in anticoagulated traumatic brain injury patients: still warranted. Am Surg. 2014;80(1):43\u201347."},{"issue":"2","key":"b25","series-title":"J Trauma Acute Care Surg","first-page":"320","article-title":"The impact of low-dose aspirin in the Brain Injury Guidelines on outcomes in traumatic brain injury: a retrospective cohort study","volume":"94","author":"Webb AJ","year":"2023","unstructured":"Webb AJ, Oetken HJ, Plott AJ, The impact of low-dose aspirin in the Brain Injury Guidelines on outcomes in traumatic brain injury: a retrospective cohort study. J Trauma Acute Care Surg. 2023;94(2):320\u2013327."},{"issue":"2","key":"b26","series-title":"P T","first-page":"95","article-title":"Pharmacological and clinical differences between low-molecular-weight heparins: implications for prescribing practice and therapeutic interchange","volume":"35","author":"Merli GJ","year":"2010","unstructured":"Merli GJ, Groce JB. Pharmacological and clinical differences between low-molecular-weight heparins: implications for prescribing practice and therapeutic interchange. P T. 2010;35(2):95\u2013105."},{"issue":"6","key":"b27","series-title":"J Trauma Acute Care Surg","first-page":"984","article-title":"Prospective validation of the brain injury guidelines: managing traumatic brain injury without neurosurgical consultation","volume":"77","author":"Joseph B","year":"2014","unstructured":"Joseph B, Aziz H, Pandit V, Prospective validation of the brain injury guidelines: managing traumatic brain injury without neurosurgical consultation. J Trauma Acute Care Surg. 2014;77(6):984\u2013988."},{"issue":"8","key":"b28","series-title":"Brain Inj","first-page":"886","article-title":"Retrospective analysis of small intracranial hemorrhage in trauma: Is acute care surgery team management alone safe?","volume":"35","author":"Murali S","year":"2021","unstructured":"Murali S, Alam F, Kroeker J, Retrospective analysis of small intracranial hemorrhage in trauma: Is acute care surgery team management alone safe? Brain Inj. 2021;35(8):886\u2013892."},{"issue":"4","key":"b29","series-title":"West J Emerg Med","first-page":"943","article-title":"Management of minor traumatic brain injury in an ED observation unit","volume":"22","author":"Wheatley MA","year":"2021","unstructured":"Wheatley MA, Kapil S, Lewis A, Management of minor traumatic brain injury in an ED observation unit. West J Emerg Med. 2021;22(4):943\u2013950."},{"issue":"3","key":"b30","series-title":"J Trauma Acute Care Surg","first-page":"483","article-title":"Safety and efficacy of brain injury guidelines at a Level III trauma center","volume":"84","author":"Martin GE","year":"2018","unstructured":"Martin GE, Carroll CP, Plummer ZJ, Safety and efficacy of brain injury guidelines at a Level III trauma center. J Trauma Acute Care Surg. 2018;84(3):483\u2013489."},{"issue":"13","key":"b31","series-title":"Brain Inj","first-page":"1093","article-title":"Diagnostic utility of Brain Injury Guidelines (BIG): systematic review and meta-analysis for prediction of neurosurgical intervention in traumatic brain injury","volume":"38","author":"Kannan S","year":"2024","unstructured":"Kannan S, Gillespie CS, Lee KS, Phang I, McMahon CJ. Diagnostic utility of Brain Injury Guidelines (BIG): systematic review and meta-analysis for prediction of neurosurgical intervention in traumatic brain injury. Brain Inj. 2024;38(13):1093\u20131100."},{"issue":"6","key":"b32","series-title":"J Trauma","first-page":"1339","article-title":"Indications for routine repeat head computed tomography (CT) stratified by severity of traumatic brain injury","volume":"62","author":"Brown CVR","year":"2007","unstructured":"Brown CVR, Zada G, Salim A, Indications for routine repeat head computed tomography (CT) stratified by severity of traumatic brain injury. J Trauma. 2007;62(6):1339\u20131355."},{"issue":"6","key":"b33","series-title":"Am J Surg","first-page":"1182","article-title":"Not every trauma patient with a radiographic head injury requires transfer for neurosurgical evaluation: application of the brain injury guidelines to patients transferred to a level 1 trauma center","volume":"214","author":"Capron GK","year":"2017","unstructured":"Capron GK, Voights MB, Moore HR III, Wall DB. Not every trauma patient with a radiographic head injury requires transfer for neurosurgical evaluation: application of the brain injury guidelines to patients transferred to a level 1 trauma center. Am J Surg. 2017;214(6):1182\u20131185."},{"issue":"3","key":"b34","series-title":"J Trauma","first-page":"475","article-title":"Routinely repeated computed tomography after blunt head trauma: does it benefit patients?","volume":"56","author":"Kaups KL","year":"2004","unstructured":"Kaups KL, Davis JW, Parks SN. Routinely repeated computed tomography after blunt head trauma: does it benefit patients? J Trauma. 2004;56(3):475\u2013481."},{"issue":"1","key":"b35","series-title":"J Am Coll Surg","first-page":"45","article-title":"A three-year prospective study of repeat head computed tomography in patients with traumatic brain injury","volume":"219","author":"Joseph B","year":"2014","unstructured":"Joseph B, Aziz H, Pandit V, A three-year prospective study of repeat head computed tomography in patients with traumatic brain injury. J Am Coll Surg. 2014;219(1):45\u201351."},{"issue":"6","key":"b36","series-title":"J Trauma Acute Care Surg","first-page":"944","article-title":"Reducing low-value interhospital transfers for mild traumatic brain injury","volume":"96","author":"Shen A","year":"2024","unstructured":"Shen A, Mizraki N, Maya M, Reducing low-value interhospital transfers for mild traumatic brain injury. J Trauma Acute Care Surg. 2024;96(6):944\u2013948."},{"issue":"3","key":"b37","series-title":"Neurosurgery","first-page":"374","article-title":"Secondary overtriage in patients with complicated mild traumatic brain injury: an observational study and socioeconomic analysis of 1447 hospitalizations","volume":"86","author":"Dengler BA","year":"2020","unstructured":"Dengler BA, Plaza-Wuthrich S, Chick RC, Muir MT, Bartanusz V. Secondary overtriage in patients with complicated mild traumatic brain injury: an observational study and socioeconomic analysis of 1447 hospitalizations. Neurosurgery. 2020;86(3):374\u2013382."},{"issue":"5","key":"b38","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Low rate of delayed deterioration requiring surgical treatment in patients transferred to a tertiary care center for mild traumatic brain injury","volume":"29","author":"Carlson AP","year":"2010","unstructured":"Carlson AP, Ramirez P, Kennedy G, McLean AR, Murray-Krezan C, Stippler M. Low rate of delayed deterioration requiring surgical treatment in patients transferred to a tertiary care center for mild traumatic brain injury. Neurosurg Focus. 2010;29(5):E3."},{"issue":"8","key":"b39","series-title":"JAMA Surg","first-page":"763","article-title":"Secondary overtriage: the burden of unnecessary interfacility transfers in a rural trauma system","volume":"148","author":"Sorensen MJ","year":"2013","unstructured":"Sorensen MJ, von Recklinghausen FM, Fulton G, Burchard KW. Secondary overtriage: the burden of unnecessary interfacility transfers in a rural trauma system. JAMA Surg. 2013;148(8):763\u2013768."},{"issue":"8","key":"b40","series-title":"Am Surg","first-page":"1368","article-title":"The price of always saying yes: a cost analysis of secondary overtriage to an urban level I trauma center","volume":"84","author":"Bukur M","year":"2018","unstructured":"Bukur M, Teurel C, Catino J, Kurek S. The price of always saying yes: a cost analysis of secondary overtriage to an urban level I trauma center. Am Surg. 2018;84(8):1368\u20131375."},{"issue":"9","key":"b41","series-title":"Health Aff (Millwood)","first-page":"1591","article-title":"The cost of overtriage: more than one-third of low-risk injured patients were taken to major trauma centers","volume":"32","author":"Newgard CD","year":"2013","unstructured":"Newgard CD, Staudenmayer K, Hsia RY, The cost of overtriage: more than one-third of low-risk injured patients were taken to major trauma centers. Health Aff (Millwood). 2013;32(9):1591\u20131599."},{"key":"b1","series-title":"Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation","article-title":"Centers for Disease Control and Prevention","year":"2014","unstructured":"Centers for Disease Control and Prevention. Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation. National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention; 2014."},{"issue":"2","key":"b2","series-title":"J Neurosurg","first-page":"584","article-title":"Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases","volume":"135","author":"Stopa BM","year":"2021","unstructured":"Stopa BM, Harary M, Jhun R, Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases. J Neurosurg. 2021;135(2):584\u2013593."},{"issue":"12","key":"b3","series-title":"JAMA","first-page":"1515","article-title":"National inventory of hospital trauma centers","volume":"289","author":"MacKenzie EJ","year":"2003","unstructured":"MacKenzie EJ, Hoyt DB, Sacra JC, National inventory of hospital trauma centers. JAMA. 2003;289(12):1515\u20131522."},{"issue":"4","key":"b4","series-title":"J Trauma Acute Care Surg","first-page":"965","article-title":"The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons","volume":"76","author":"Joseph B","year":"2014","unstructured":"Joseph B, Friese RS, Sadoun M, The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons. 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Trauma Surg Acute Care Open. 2020;5(1):e000483."},{"issue":"4","key":"b7","series-title":"J Neurosurg","first-page":"661","article-title":"Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study","volume":"99","author":"Spektor S","year":"2003","unstructured":"Spektor S, Agus S, Merkin V, Constantini S. Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study. J Neurosurg. 2003;99(4):661\u2013665."},{"issue":"1","key":"b8","series-title":"J Surg Res","first-page":"287","article-title":"Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: a prospective study","volume":"186","author":"Joseph B","year":"2014","unstructured":"Joseph B, Aziz H, Pandit V, Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: a prospective study. 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