Minor head injury

Nearly 1 million patients with minor head trauma are evaluated annually in the U.S.

Definition of minor head trauma involves presentation of a patient with normal or minimally altered consciousness (Glascow Coma Scale 13-15) following head trauma after which there can be a short period of amnesia or loss of consciousness.

CT scan yields for intracranial lesions is low, estimated to be 0.7%-3.7%.

Most patients do not have intracranial complications nor do they require neurosurgical interventions.

New Orleans Criteria: patients older than 3 years old with a Glascow Coma Scale score of 15 on presentation without neurological deficits do not require brain CT scan unless: headaches, vomiting, age greater than 60 years, alcohol intoxication, persistent amnesia, visible trauma above the clavicle or seizures are present.

Canadian CT Head Rule study involved patients over the age of 16 years with Glascow Coma Scale (GCS) score of 3 to 15 without neurologic deficit, presence of anticoagulation, or seizure and indicted that CT scans were not necessary unless one of the following is present: GCS less than 15 two hours after injury, suspected open or depressed skull fracture, any signs of basilar skull fracture, 2 or more episodes of vomiting, age older than 65 years, amnesia before impact of greater than 30 minutes, or a dangerous mechanism of injury.

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