[Revised practice guideline on mild traumatic head/brain injury: mainly for secondary care].

Recommendations for referral of patients with mild traumatic head or brain injury to hospital-based emergency departments aim to minimize the risk of missing severe intracerebral injuries. As these recommendations were derived from secondary care data, application of the recommendations in general practice is likely to reduce the positive predictive value for severe intracerebral injury and may, therefore, result in more unnecessary referrals. Instead, in primary care an advice to wake up the patient several times during the first 24 hours after trauma may help to notice in time the development of severe intracranial pathology.