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This systematic review of the literature found four findings associated with intercranial hemorrhage in older patients after a fall. They were: focal neurologic findings, external signs of trauma on the head, loss of consciousness, and male sex.
We still need better studies as this is completely based on the quantity and quality of literature available to review. This information is not enough to change liberal CT imagining in older patients after a fall. It is the beginning of the study process.
References
Dubucs X, Gingras V, Boucher V, Carmichael PH, Ruel M, De Wit K, Grewal K, Mercier É, Blanchard PG, Benhamed A, Charpentier S, Émond M. Risk Factors for Traumatic Intracranial Hemorrhage in Older Adults Sustaining a Head Injury in Ground-Level Falls: A Systematic Review and Meta-analysis. Ann Emerg Med. 2025 Jul 22:S0196-0644(25)00313-0. doi: 10.1016/j.annemergmed.2025.05.021. Epub ahead of print. PMID: 40699169.