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Los subtipos de hemorragia intracraneal combinada no deben cambiar los criterios modificados de las Directrices sobre
Emily H Johnson1, Janet S Lee, Michael W Cripps
1From the Department of Trauma and Acute Care Surgery (E.H.J., J.S.L., T.J.S.), UCHealth Memorial Hospital Trauma Services; and Department of Surgery (E.H.J., J.S.L., M.W.C., R.C.M.), University of Colorado Anschutz Medical Campus, Aurora, Colorado.
The journal of trauma and acute care surgery
|February 11, 2026
Resumen
Las guías modificadas de lesiones cerebrales (mBIG) clasifican eficazmente a los pacientes con lesiones cerebrales traumáticas. La hemorragia intracraneal combinada (CICH) muestra un aumento de la progresión radiográfica, pero no un deterioro clínico en comparación con la ICH aislada.
Área de la Ciencia:
- Trauma Cirugía cirugía cirugía.
- La neurocirugía es la neurocirugía.
- Medicina de emergencia Medicina de emergencia.
Sus antecedentes:
- Las Directrices modificadas de Lesiones Cerebrales (mBIG) se establecen para la lesión cerebral traumática (TBI) con triaje de hemorragia intracraneal (ICH).
- mBIG no distingue entre ICH aislado y ICH combinado (cICH).
- Este estudio investiga si el cICH requiere diferentes protocolos de triaje que el ICH aislado.
Objetivo del estudio:
- Evaluar si los pacientes con múltiples subtipos de ICH (cICH) necesitan diferentes estrategias de triaje en comparación con el ICH aislado.
- Para comparar los resultados clínicos entre pacientes con ICH aislado y cICH dentro de los criterios de mBIG.
Principales métodos:
- Estudio retrospectivo de pacientes adultos clasificados como mBIG 1 o 2.
- Comparación de pacientes con CICH (≥2 subtipos) versus CICI aislado.
- Resultado primario: deterioro clínico; resultados secundarios: progresión radiográfica, intervención neuroquirúrgica, utilización de los recursos.
Principales resultados:
- El 29,7% de los pacientes tenían cICH.
- Los pacientes con cICH tenían puntuaciones más altas de gravedad de las lesiones y estadías más largas en UCI.
- No hay diferencias significativas en el deterioro clínico, la intervención neuroquirúrgica o las tasas de readmisión entre los grupos aislados de ICH y cICH.
Conclusiones:
- La ICH combinada (cICH) se asocia con un aumento de la progresión radiográfica y el uso de recursos, pero no con un deterioro clínico.
- Las directrices actuales de mBIG parecen apropiadas tanto para el ICH aislado como para el cICH.
- La escalada de la atención debe basarse en el deterioro neurológico u otras características de alto riesgo, no solo en la presencia de CICH.
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