Overview
NICE has produced guidelines on when to perform a CT scan in people presenting with head injuries. The guidelines for adults are discussed here.
This page will cover the guidelines regarding CT head scans for children (people under 16 years old)
CT Head Indications
Overview
Perform an immediate CT head scan within 1 hour if any of the following apply:
- Suspicion of non-accidental injury
- Post-traumatic seizure
- On initial assessment:
- A Glasgow coma score (GCS) of <14 or
- If under 1 year old <15 using the paediatric GCS
- If GCS <15 at 2 hours post-injury
- Suspected open/depressed skull fracture or tense fontanelle
- Signs of a basal skull fracture (haemotympanum, panda eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign)
- Focal neurological deficits (e.g. difficulties with understanding, speaking, reading, or writing, decreased sensation, weakness, vision changes, balance problems, amnesia etc.)
- Babies <1 with a bruise, swelling, or laceration >5 cm on the head
- Loss of consciousness lasting >5 minutes (witnessed)
- Abnormal drowsiness
- ≥3 or more discrete episodes of vomiting
- Dangerous mechanism of injury (e.g. high-speed road traffic accident as a pedestrian, cyclist, or vehicle occupant, fall from a height of ≥3 m, high-speed injury from a projectile or object)
- Amnesia (retrograde or anterograde) >5 minutes
- Any current bleeding or clotting disorder
