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Aims and Objectives Mild head injury in patients taking direct oral anticoagulants (DOACs) is a frequent presentation to Emergency Departments. Clinicians must balance the risk of intracranial haemorrhage (ICH) against unnecessary imaging and resource use. The current 2023 NICE head injury guideline offers limited direction, advising consideration of a CT head in patients not meeting standard imaging criteria. This study aimed to characterise the risk of ICH after mild head injury in patients on DOACs.Method and Design This interim report from an ongoing cohort study includes consecutive mild head injury patients (GCS 13–15) on DOACs who underwent CT head between July 2024–January 2025. Standardised clinical data on symptoms and signs of head injury were recorded prospectively by clinicians within CT head request forms. Demographic data and imaging findings were collected from electronic case records retrospectively. ICH risk was calculated for: (a) ‘CT recommended’ patients meeting standard NICE imaging criteria, and (b) those in the ‘consider CT’ group—further divided into symptomatic and asymptomatic subgroups. Data collection continues until June 2025.Results and Conclusion Among 626 included patients (median age 84; 92% >65 years; 26% with dementia; 17% recurrent fallers), 48% met standard NICE CT criteria. This group had a 7.3% risk of ICH (95% CI 4.6-10.9, n=22/301). In ‘consider’ CT cases, the risk of ICH was lower at 1.8% (95% CI 0.7-4.0, n=6/325). In this group, risk ranged from 4.7% (95% CI 1.5-10.7, n=5/106) in symptomatic cases to 0.5% (95% CI 0.1-2.5, n=1/219) in asymptomatic cases. No ‘consider CT’ cases required neurosurgery, anticoagulation reversal or anti-fibrinolytic treatment. Results for the full cohort will be available by February 2026.ICH risk in DOAC-treated patients with mild head injury who do not meet standard NICE criteria is very low—particularly in asymptomatic cases. Confirmation in a larger cohort could support safely reducing unnecessary CT imaging.