Delayed intracranial hemorrhage (ICH) is the most feared complication of blunt head trauma in anticoagulated elderly patients. Current guidelines recommend cranial computed tomography (CT) for patients who have sustained blunt head trauma.¹ Other recommendations suggest that patients receiving any anticoagulation and/or antiplatelet therapy be observed for a minimum of 24 hours and have a repeated head CT scan, even after initial normal CT findings.² Studies have reported rates of delayed ICH in this patient population between 0.1% and 7%.³ In this issue of JAMA Surgery, Chenoweth et al⁴ demonstrate that 1 of 343 patients (0.3%) receiving anticoagulation and/or antiplatelet therapy developed delayed ICH and therefore conclude that repeated imaging and observation may not be necessary.

延迟颅内出血（ICH）是抗凝老年患者最受钝性颅脑外伤的并发症。当前的指南建议对持续钝性颅脑外伤的患者进行颅骨计算机断层扫描（CT）。¹其他建议建议，即使在最初的正常CT表现之后，也应观察接受任何抗凝和/或抗血小板治疗的患者至少24小时并进行重复的头部CT扫描。²研究报告了该患者人群中迟发性ICH的发生率在0.1％至7％之间。³ Chenoweth等在本期《JAMA外科》中⁴ 结果表明，接受抗凝和/或抗血小板治疗的343名患者中有1名（0.3％）出现了ICH延迟，因此得出结论，可能不需要重复成像和观察。