Table of Contents

NICE 2014 indications for head CT scan within 1 hour
- if ONE or MORE of
- or MORE THAN ONE of
references

paediatric head injury

see also:

paediatric emergency medicine
RCH guideline - head injury
NSW NETS - head injury (pdf)
head injury in the adult patient
Monash Concussion Clinic for children and adults - a low cost clinical psychology/neuropsychology service - an income tested sliding fee applies
Serum glial fibrillary acidic protein levels are 97% accurate up to 7 days post injury of detecting brain injury such as concussion… may lead to a new biomarker that could reduce CT scans ¹⁾

NICE 2014 indications for head CT scan within 1 hour

if ONE or MORE of

suspicion of NAI
post-traumatic seizure and no PH epilepsy
GCS < 14 on arrival (<15 if < 1 yr old)
GCS < 15 at 2hrs
signs of base of skull #
focal neurology
suspected open # or depressed skull #
tense fontanelle
swelling / bruise / laceration > 5cm in those under 1 yr old
on warfarin (scan can be delayed up to 8hrs??)

or MORE THAN ONE of

witnessed LOC > 5 min
abnormal drowsiness
> 3 discrete vomiting episodes
dangerous mechanism such as pedestrian, cyclist, vehicle occupant, fall > 3m, high speed injury from projectile or other object
retrograde or anterograde amnesia > 5 min

references

NICE Head Injury Clinical Guideline CG176 (pdf)

¹⁾

JAMA Neurology 2016. Brophy G, Welch R, Papa L, et al. Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury.