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Trauma

Excluding severe intracranial injury in adults with minor head trauma

This KCE has read for you was prepared by Dominique Roberfroid and Lorena San Miguel

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KEY MESSAGES FROM THE PUBLICATION

  • Although most adult patients with minor head trauma will not have a serious intracranial injury, CT scan is often used in the diagnosis process.
  • The New Orleans Criteria and the Canadian CT Head Rule are two clinical decision rules which reliably detect adult patients with very low risk of serious intracranial injury. For these patients a CT can in this way be avoided.
  • In a study population with a prevalence of 7.1% (95%CI: 6.8%-7.4%) of severe intracranial injury following a minor head trauma, the absence of any of the features of the Canadian CT Head Rule lowered the probability of severe injury to 0.31% (95%CI: 0%-4.7%). The absence of all the New Orleans Criteria findings lowered it to 0.61% (95%CI: 0.08%-6.0%).
  • Combinations of history and physical examination features in clinical decision rules can identify patients with minor head trauma at low risk of severe intracranial injuries. Applying such clinical decision rules could allow limiting the number of CT Scans.
published on 06-12-2016