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The PECARN cervical spine injury (CSI) prediction rule performed similarly across all pediatric age groups and was not meaningfully improved by creating age-specific rules, supporting its use from infancy through adolescence.
Source
Comparison of Cervical Spine Injury Prediction Rule Across Ages. Pediatrics. 2026 May 1:e2025075341. doi: 10.1542/peds.2025-075341. Epub ahead of print. PMID: 42061904.
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The Brain Trauma Foundation guidelines on penetrating traumatic brain injury (pTBI) offer helpful tips to improve survival.
Source
Executive summary of the Brain Trauma Foundation Guidelines for the Management of Penetrating Traumatic Brain Injury, Second Edition. J Trauma Acute Care Surg. 2026 Mar 1;100(3):371-379. doi: 10.1097/TA.0000000000004868. Epub 2026 Jan 9. PMID: 41700745.
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Patients with normal blood levels of certain brain biomarkers after mild traumatic brain injury were unlikely to have intracranial lesions on CT, suggesting that biomarker testing may help reduce unnecessary CT imaging.
Source
Can the Association of the Biomarkers GFAP and UCH-L1 Predict Intracranial Injury After Mild Traumatic Brain Injury in Adults? A Systematic Review and Meta-Analysis. Ann Emerg Med. 2026 Feb;87(2):167-180. doi: 10.1016/j.annemergmed.2025.03.018. Epub 2025 Apr 24. PMID: 40272329.
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Combined elevation in two blood biomarkers (GFAP and UCH-L1) showed high sensitivity and negative predictive value (NPV) for positive findings on head CT in anticoagulated patients with mild traumatic brain injury, but were not helpful for identifying who would develop post-concussive syndrome.
Source
Prognostic value of GFAP and UCHL-1 biomarkers in high-risk mild traumatic brain injury: A prospective longitudinal study of short- and long-term outcomes. Am J Emerg Med. 2026 Mar;101:41-47. doi: 10.1016/j.ajem.2025.12.021. Epub 2025 Dec 22. PMID: 41455435.
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Approaches to repeat CT scans in traumatic brain injuries (TBIs) are highly variable. This study recommends a risk-stratified approach based upon injury severity, patients’ clinical factors, and timing of initial CT.
Source
Timing Is Everything: A Systematic Review of Optimal Repeat Computed Tomography Protocols in Traumatic Brain Injury. J Neurotrauma. 2025 Nov 24. doi: 10.1177/08977151251401545. Epub ahead of print. PMID: 41293885.
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Idiopathic intracranial hypertension is an obesity-associated disorder, most often seen in young women, which causes elevated intracranial pressure and papilledema, leading to headaches and potential vision loss. Diagnosis relies on neuroimaging and lumbar puncture, while treatment focuses on weight reduction, acetazolamide, and emerging GLP-1 agonists, with surgery reserved for vision-threatening cases.
Source
Idiopathic Intracranial Hypertension. N Engl J Med. 2025 Oct 9;393(14):1409-1419. doi: 10.1056/NEJMra2404929. PMID: 41061234.
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The PECARN cervical spine injury prediction rule performed well when applied by EMS clinicians, with high sensitivity and negative predictive value, suggesting it may help reduce unnecessary spinal motion restriction in children after blunt trauma.
Source
Performance of the PECARN cervical spine injury prediction rule based on EMS clinician observations. J Trauma Acute Care Surg. 2025 Aug 21. doi: 10.1097/TA.0000000000004772. Epub ahead of print. PMID: 40836370.
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In this retrospective study on optic nerve sheath diameter (ONSD), the sagittal measurement was statistically disparate from the transverse measurement, with the authors recommending the transverse approach.
Source
Optic Nerve Sheath Diameter: Which Axis Should Be Measured? J Neuroimaging. 2025 Jul-Aug;35(4):e70076. doi: 10.1111/jon.70076. PMID: 40754891; PMCID: PMC12319288.
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This pooled appraisal supports the potential efficacy and expanded role of endovascular therapy (EVT) in a broader stroke population than once thought, particularly those patients with large core infarcts across a wider treatment window.
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Mechanical Thrombectomy for Large Ischemic Stroke: A Critical Appraisal of Evidence From 6 Randomized Controlled Trials. Stroke. 2025 Jul;56(7):1917-1927. doi: 10.1161/STROKEAHA.125.050402. Epub 2025 May 20. PMID: 40391430
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Both the Ottawa and Emerald subarachnoid hemorrhage (SAH) rules are highly sensitive for excluding SAH but have low specificity and do not reduce CT utilization.
Source
Diagnostic Accuracy and Application of Subarachnoid Hemorrhage Decision Rules Among Patients With Non-Traumatic Acute Headache: A Systematic Review and Meta-Analysis. Acad Emerg Med. 2025 Jul 2. doi: 10.1111/acem.70087. Epub ahead of print. PMID: 40605232