Head injury

Question 1

What are the indications for CT scan of a head injury? (x2)

Answer 1

• CRITERIA FOR IMMEDIATE CT: GCS less than 13 on arrival at ED, GCS less than 15 2h post-incident, post-traumatic seizure, focal neurological deficit, at least 2 episodes of vomiting, suspected skull fracture
• CRITERIA FOR URGENT CT (within 8 hours): any head injury on warfarin, loss of consciousness or amnesia PLUS over 65, fall from at least 1m, fall from at least 5 stairs, pedestrian v vehicle, bicycle v vehicle, or more than 30min amnesia before injury.

Question 2

What is a focal neurological deficit?

Answer 2

Problems restricted to a particular part of the body, for example difficulties understanding, speaking, reading, decreased sensation, loss of balance, generalised weakness, visual changes, abnormal reflexes.

Question 3

What are the most common findings on CT in head injuries?

Answer 3

Haematoma, and cerebral contusions (hyperdense regions of brain tissue)