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Head Injury CT Indications in Concussion

Aka: Head Injury CT Indications in Concussion
  1. See Also
    1. Head CT
    2. Head Injury CT Indications in Adults
    3. Head Injury CT Indications in Children
    4. Concussion
  2. Indications: Head CT for Concussion in age over 16 years old (ACEP Guidelines)
    1. Inclusion Criteria
      1. Presenting within 24 hours for non-Penetrating Trauma and GCS of 14 or 15
    2. Patients with loss of consciousness or amnesia (and at least one of the following criteria)
      1. Diffuse Headache
      2. Vomiting
      3. Age over 60 years
      4. Alcohol Intoxication or other drug Intoxication
      5. Short Term Memory deficit
      6. Signs of Trauma above the clavicles
      7. Seizures
      8. GCS Score less than 15
      9. Focal neurologic deficits
      10. Coagulopathy
    3. Patients without loss of consciousness or amnesia (and at least one of the following criteria)
      1. Severe Headache
      2. Vomiting
      3. Age over 65 years
      4. Basilar Skull Fracture signs
      5. GCS Score less than 15
      6. Focal neurologic deficit
      7. Coagulopathy
      8. Significant Mechanism of injury
        1. Vehicle ejection
        2. Pedestrian struck by vehicle
        3. Fall from height >3 feet or 5 stairs
  3. Indications: Head CT for Concussion in age 2 to 20 years old (AAFP and AAP Guidelines)
    1. Inclusion Criteria
      1. Presenting within 24 hours for isolated Closed Head Injury
    2. Imaging for any of criteria met below
      1. Loss of consciousness >60 seconds
        1. Consider CT Head for even brief loss of consciousness
      2. Skull Fracture evidence
      3. Focal neurologic deficit
  4. References
    1. (1999) Pediatrics 104(6): 1407-15 [PubMed]
    2. Jagoda (2008) Ann Emerg Med 52(6): 714-48 [PubMed]
    3. Scorza (2012) Am Fam Physician 85(2): 123-32 [PubMed]

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