Abstract
Answer D
Computerized tomography (CT) imaging of the head is the primary investigation of choice for clinically important brain injury. Immediate CT scan is indicated if:
GCS less than 13 when first assessed GCS less than 15 when assessed 2 hours after the injury Suspected open or depressed skull fracture Sign of fracture at skull base Post-traumatic seizure Focal neurological deficit More than one episode of vomiting Amnesia of events more than 30 minutes before impact If none of the above are present, an immediate CT scan is still indicated if there has been any amnesia or loss of consciousness since the injury in association with: Age 65 years or older Coagulopathy (including treatment with warfarin) Dangerous mechanism of injury (including fall from greater than 1 m or 5 stairs)
NICE Clinical Guideline 56—Head Injury; www.nice.org.uk