Head Injury CT Guidelines

Question 1

When would an adult be given a CT scan after head injury?

Answer 1

GCS less than 13 on initial assessment in ED
GCS less than 15 2 hours after assessment
Suspected open or depressed skull fracture
Sign of basal skull fracture (haemotympanum, panda eyes, CSF leak, Battle’s sign)
Post-traumatic seizure
Focal neurological deficit
More than 1 episode of vomiting

Question 2

How fast should you CT scan someone if they fit the criteria?

Answer 2

Within 1 hour

Question 3

What risk factors would a patient have that means you should CT scan within 8 hours of head injury?

Answer 3

If lost consciousness or amnesia
AND
65 and older
OR
History of bleeding and clotting disorders
OR
Dangerous mechanism of injury
OR
More than 30 mins retrograde amnesia of events immediately before injury

Question 4

What is different in the CT scan criteria for children?

Answer 4

Also if suspect NAI
For children under 1 year, presence of bruise, swelling or laceration of more than 5 cm on the head.