A decision-support system and computer implemented method automatically measures the midline shift in a patient's brain using Computed Tomography (CT) images. The decision-support system and computer implemented method applies machine learning methods to features extracted from multiple sources, including midline shift, blood amount, texture pattern and other injury data, to provide a physician an estimate of intracranial pressure (ICP) levels. A hierarchical segmentation method, based on Gaussian Mixture Model (GMM), is used. In this approach, first an Magnetic Resonance Image (MRI) ventricle template, as prior knowledge, is used to estimate the region for each ventricle. Then, by matching the ventricle shape in CT images to the MRI ventricle template set, the corresponding MRI slice is selected. From the shape matching result, the feature points for midline estimation in CT slices, such as the center edge points of the lateral ventricles, are detected. The amount of shift, along with other information such as brain tissue texture features, volume of blood accumulated in the brain, patient demographics, injury information, and features extracted from physiological signals, are used to train a machine learning method to predict a variety of important clinical factors, such as intracranial pressure (ICP), likelihood of success a particular treatment, and the need and / or dosage of particular drugs.