Template:MBig - Revision history

Ostermayer: Update SAH links to point to new specific pages (Traumatic SAH for tSAH; Aneurysmal SAH in scope note)

2026-04-28T04:23:54Z

Update SAH links to point to new specific pages (Traumatic SAH for tSAH; Aneurysmal SAH in scope note)

← Older revision		Revision as of 04:23, 28 April 2026
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	''Scope: mBIG applies ONLY to '''traumatic''' intracranial hemorrhage in adults with [[mild traumatic brain injury]] (GCS 13–15). It is '''not''' applicable to spontaneous/aneurysmal [[subarachnoid hemorrhage]], spontaneous [[hemorrhagic stroke\|intracerebral hemorrhage]], or any non-traumatic intracranial hemorrhage.''		''Scope: mBIG applies ONLY to '''traumatic''' intracranial hemorrhage in adults with [[mild traumatic brain injury]] (GCS 13–15). It is '''not''' applicable to spontaneous/aneurysmal [[aneurysmal subarachnoid hemorrhage\|subarachnoid hemorrhage]], spontaneous [[hemorrhagic stroke\|intracerebral hemorrhage]], or any non-traumatic intracranial hemorrhage.''


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	*No [[seizure]]		*No [[seizure]]
	*No [[vomiting\|emesis]]		*No [[vomiting\|emesis]]
	*Isolated [[subdural hemorrhage\|SDH]] ≤4 mm, isolated [[epidural hemorrhage\|EDH]] ≤4 mm, isolated [[subarachnoid hemorrhage\|tSAH]] ≤4 mm, cerebral contusion ≤2 cm, or intraventricular hemorrhage ≤2 mm		*Isolated [[subdural hemorrhage\|SDH]] ≤4 mm, isolated [[epidural hemorrhage\|EDH]] ≤4 mm, isolated [[traumatic subarachnoid hemorrhage\|tSAH]] ≤4 mm, cerebral contusion ≤2 cm, or intraventricular hemorrhage ≤2 mm
	*No herniation or significant mass effect on CT		*No herniation or significant mass effect on CT
	*Neurologically intact		*Neurologically intact

Ostermayer: Add scope note clarifying mBIG applies only to traumatic ICH, not spontaneous/aneurysmal hemorrhage

2026-04-28T04:07:53Z

Add scope note clarifying mBIG applies only to traumatic ICH, not spontaneous/aneurysmal hemorrhage

← Older revision		Revision as of 04:07, 28 April 2026
Line 1:		Line 1:
			''Scope: mBIG applies ONLY to '''traumatic''' intracranial hemorrhage in adults with [[mild traumatic brain injury]] (GCS 13–15). It is '''not''' applicable to spontaneous/aneurysmal [[subarachnoid hemorrhage]], spontaneous [[hemorrhagic stroke\|intracerebral hemorrhage]], or any non-traumatic intracranial hemorrhage.''


	===mBIG 1 (lowest risk)===		===mBIG 1 (lowest risk)===

Ostermayer: Created page with " ===mBIG 1 (lowest risk)=== All of the following must be true: GCS 15 No loss of consciousness (LOC) No seizure No emesis Isolated SDH ≤4 mm, isolated EDH ≤4 mm, isolated tSAH ≤4 mm, cerebral contusion ≤2 cm, or intraventricular hemorrhage ≤2 mm No herniation or significant mass effect on CT *Neurologically intact Disposition: No neurosurgical consultation requir..."

2026-04-28T03:50:34Z

Created page with " ===mBIG 1 (lowest risk)=== All of the following must be true: *GCS 15 *No loss of consciousness (LOC) *No seizure *No emesis *Isolated SDH ≤4 mm, isolated EDH ≤4 mm, isolated tSAH ≤4 mm, cerebral contusion ≤2 cm, or intraventricular hemorrhage ≤2 mm *No herniation or significant mass effect on CT *Neurologically intact Disposition: No neurosurgical consultation requir..."

New page

===mBIG 1 (lowest risk)===
All of the following must be true:
*GCS 15
*No loss of consciousness (LOC)
*No [[seizure]]
*No [[vomiting|emesis]]
*Isolated [[subdural hemorrhage|SDH]] ≤4 mm, isolated [[epidural hemorrhage|EDH]] ≤4 mm, isolated [[subarachnoid hemorrhage|tSAH]] ≤4 mm, cerebral contusion ≤2 cm, or intraventricular hemorrhage ≤2 mm
*No herniation or significant mass effect on CT
*Neurologically intact

Disposition: No neurosurgical consultation required; observation in non-monitored setting acceptable; repeat CT imaging not required if clinically stable; may be appropriate for discharge with reliable follow-up.

===mBIG 2 (intermediate risk)===
Meets any of the following (but does not meet mBIG 3 criteria):
*GCS 13–14, OR
*LOC, OR
*Isolated [[seizure]], OR
*Emesis, OR
*CT findings larger than mBIG 1 thresholds but without herniation/significant mass effect

Disposition: Neurosurgical consultation warranted; admission to step-down or monitored unit; repeat head CT in 4–6 hours or per neurosurgical guidance.

===mBIG 3 (highest risk)===
Any of the following:
*GCS <13 (note: if GCS <13, patient may not strictly qualify as "mild TBI" — manage per [[moderate-to-severe traumatic brain injury]] pathway)
*Any herniation on CT
*Significant mass effect (midline shift >5 mm, cisternal effacement)
*Bilateral or mixed intracranial hemorrhage pattern with neurologic decline
*Neurovascular injury identified

Disposition: Emergent neurosurgical consultation; ICU admission; operative intervention frequently required.