Imaging

Question 1

NICE criteria for CT head within 1 hour:

Answer 1

• GCS < 13 on initial assessment
• GCS < 15 at 2 hours after injury on assessment in the emergency department
• Suspected open or depressed skull fracture
• Any sign of basal skull fracture (haemotympanum / battle’s sign / panda eyes / CSF leak)
• Post-traumatic seizure
• Focal neurological deficit
• More than one episode of vomiting since the head injury

Question 2

Haemotympanum indication for CT head?

Answer 2

Yes, because sign of basal skull fracture

Question 3

NICE CT scan post head injury within 8 hours

Answer 3

• Anticoagulated

Loss of consciousness or amnesia since the head injury AND:

• Age > 65 years
• A history of bleeding or clotting disorder
• Dangerous mechanism of injury (a pedestrian
  or cyclist struck by a motor vehicle, an occupant ejected from a motor vehicle or a fall from height of > than 1 metre or 5 stairs)
• More than 30 minutes’ retrograde amnesia of events immediately before the head injury