Homicide Squad detectives have charged a man following an incident where a number of pedestrians were struck in the Melbourne CBD on Thursday.

Saeed Noori, 32, of Heidelberg West, briefly appeared in the Melbourne Magistrates Court on Saturday wearing a grey t-shirt, charged with 18 counts of attempted murder and one count of conduct endangering life.

The charges follow an incident where it is alleged a white 4WD struck a number of pedestrians at the intersection of Flinders and Elizabeth Street.

Mr Noori covered his face with his hands and looked down during the 3pm hearing as prosecutors read details of the incident and indicated more charges are being considered.

The court was told the motive remained under investigation.

When asked if there were any custody management issues, Mr Noori’s defence lawyer said: “Yes, your honour, first and foremost mental health.”

He also said the accused man had physical health issues.

Magistrate Bob Kumar remanded Mr Noori in custody to face a filing hearing on December 27. He did not apply for bail.

He also ordered that Mr Noori be seen by a nurse for physical and psychiatric issues.

At the end of the hearing, Mr Noori uttered a quiet, “Thank you,” before being led from the dock into custody.

Mr Noori’s mother was in court for the hearing and cried when her son entered the courtroom, the ABC reported.

Earlier, Mr Noori, a mentally ill Afghan refugee and Australian citizen, was transported just before 9am to the Melbourne West police station where he was formally interviewed for several hours.

Assistant Commissioner Stephen Leane told reporters on Saturday at 11am that he had a “firm belief” his actions on Thursday night were a “deliberate act”.

“The motivations for that act, we’ll work through,” he said.

At 4.40pm on Thursday, Noori allegedly drove a white, four-door Suzuki Vitara onto tram tracks, mowing down pedestrians in Flinders Street and injuring 19 people.

The white car allegedly pulled out of traffic and onto the tracks, accelerating into the crowd of Christmas shoppers before crashing into a bollard.

An 83-year-old from Northcote and two South Koreans in their 60s, remain in a critical condition and another 12 people remain in hospital.

All up, 18 pedestrians were admitted to hospital, including nine foreign nationals from China, Italy, India, Venezuela, Ireland, South Korea, and New Zealand.

—with AAP