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Head Injury CT Indications in AdultsAka: Head Injury CT Indications, CT Head Indications in Head Injury, Canadian CT Head Rule

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  1. See Also
    1. Head Injury CT Indications in Children
    2. Head CT
    3. Head Injury
  2. General
    1. Image all moderate and severe head injuries
    2. Head CT indicated in only select mild Head Injury
    3. Recommendations listed here are for adults
  3. Protocol: Canadian CT Head Rule (for mild Head Injury)
    1. See Management of Mild Head Injury for definition
    2. High risk indications for Head CT
      1. Glasgow Coma Scale <15 at 2 hours after injury
      2. Open or depressed skull Fracture
      3. Vomiting (Two or more episodes)
      4. Age 65 years or over (other studies suggest age 60)
      5. Basal skull Fracture signs
        1. Hemotympanum
        2. Periorbital Bruising (Raccoon's Eyes)
        3. Mastoid process Ecchymosis (Battle's Sign)
        4. Cerebrospinal fluid leakage from ear or nose
    3. Moderate risk indications for Head CT
      1. Pre-trauma amnesia lasting longer than 30 minutes
      2. High risk mechanism of injury
        1. Pedestrian in motor vehicle accident
        2. Passenger ejected from vehicle
        3. Fall from height over 3 feet or 5 stairs
    4. References
      1. Stiell (2001) Lancet 357:1394
  4. Additional Head CT Indications (from other studies)
    1. Drug or Alcohol intoxication
    2. Physical findings of trauma above clavicle
    3. Seizure
    4. Coagulopathy
    5. Focal neurologic deficit
  5. References
    1. Borczuk (1995) Ann Emerg Med 25:731
    2. Jagoda (2002) Ann Emerg Med 40:231

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