mdcalc.com | Canadian CT Head Injury/Trauma Rule

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Units: US SI

Canadian CT Head Injury/Trauma Rule

Canadian CT Head Rules Only Apply to GCS 13-15 Patients with Witnessed LOC, Amnesia to the Head Injury Event, or Confusion
GCS < 15 at 2 hours post-injury?	Yes
Suspected open or depressed skull fracture?	Yes
Any sign of basilar skull fracture? (hemotympanum, racoon eyes, cerebrospinal fluid oto-/rhinorrhea, Battle’s sign)	Yes
≥ 2 episodes of vomiting?	Yes
Age ≥ 65?	Yes
Retrograde Amnesia to the Event ≥ 30 minutes?	Yes
"Dangerous" Mechanism? (Pedestrian struck by motor vehicle, Occupant ejected from motor vehicle, or Fall from > 3 feet or > 5 stairs.)	Yes
If none of the above are present: The Canadian Head CT Rule suggests a head CT is not necessary for this patient (sensitivity 83-100% for all intracranial traumatic findings, sensitivity 100% for findings requiring neurosurigcal intervention).

Stiell IG, Clement CM, Rowe BH, Schull MJ, Brison R, Cass D, Eisenhauer MA, McKnight RD, Bandiera G, Holroyd B, Lee JS, Dreyer J, Worthington JR, Reardon M, Greenberg G, Lesiuk H, MacPhail I, Wells GA. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. JAMA. 2005 Sep 28;294(12):1511-8. PubMed PMID: 16189364. Free Text at JAMA

Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA. 2005 Sep 28;294(12):1519-25. PubMed PMID: 16189365. Free Text at JAMA

Stiell IG, Wells GA, Vandemheen K, Clement C, Lesiuk H, Laupacis A, McKnight RD, Verbeek R, Brison R, Cass D, Eisenhauer ME, Greenberg G, Worthington J. The Canadian CT Head Rule for patients with minor head injury. Lancet. 2001 May 5;357(9266):1391-6. PubMed PMID: 11356436.

Posted in: Neurologic • Surgery

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