CEREBRAL Trial Results

19.04.2024

Study results:

CEREBRAL Trial – Head injury in older adults presenting to the ambulance service

What is a retrospective case-control study?

A retrospective case-control study is a study that compares two groups using data that already exists. In the CEREBRAL study the two groups were those patients that had a traumatic intracranial haemorrhage and those that hadn’t.

What was the CEREBRAL study looking at?

The study looked at patients who were over 60 years that were seen by South East Coast Ambulance Service (SECAmb) and taken to an emergency department after suffering a possible traumatic brain injury (head injury). The study wanted to know if the ambulance staff have enough information when at the scene of the head injury to assess whether this age group of people were at a high risk of having a traumatic intracranial haemorrhage.

What is a traumatic intracranial haemorrhage?

A traumatic intracranial haemorrhage is when a blood vessel in or around the brain bursts causing a “brain bleed”. This can then put pressure on the surrounding brain tissue.

What did the study do?

The study looked at 2111 patients who went to the emergency department at several Trusts to see how many had a CT scan (a specialised X-Ray test) of the head. It then looked at how many scans showed the person had had a traumatic intracranial haemorrhage (brain bleed). Of those patients that went to the emergency department 76 per cent (1600) had a head CT scan with 10 per cent (162 patients) shown to have had a traumatic intracranial haemorrhage (brain bleed).

Medway NHS Foundation Trust recruited 303 patients to the study.

What did the CEREBRAL study show?

The study showed current guidelines for older adults, on who should be taken to hospital following a traumatic head injury, may need reviewing. This was more so for those older adults who were not showing any symptoms of a brain bleed or head injury. Further work is needed to determine which head injury patients over the age of 60 years should be taken to the emergency department.

Head injury in older adults presenting to the ambulance service: who do we convey to the emergency department, and what clinical variables are associated with an intracranial bleed? A retrospective case–control study – University of Surrey