EAD INJURY IS ONE OF THE most common injuries in the Western world with an estimated incidence of hospitaltreated patients with minor head injury of 100 to 300 per 100 000 population. 1 Minor head injury is commonly defined as blunt trauma to the head, after which the patient has lost consciousness for less than 15 minutes or has a short posttraumatic amnesia of less than 1 hour, or both, as well as a normal or minimally altered mental status on presentation (a Glasgow Coma Scale [GCS] score of 13-15). 2,3 Intracranial complications of minor head injury are infrequent (6%-21%) but potentially life-threatening and may require neurosurgical intervention in a minority of cases (0.4%-1.0%). 3-8 Neurocranial injury that does not require See also pp 1511 and 1551 and Patient Page.

The authors propose the highly sensitive CHIP prediction rule for the selective use of CT in patients with minor head injury with or without loss of consciousness.

Omitting arm raising results in lower but acceptable image quality and a substantially higher effective radiation dose. Hence, effort should be made to position the arms above the shoulder when scanning trauma patients. Clinical trial registration no. NCT00228111.

Selecting patients with MHI for CT renders cost savings and may be cost-effective, provided the sensitivity for the identification of patients who require neurosurgery is extremely high. Uncertainty regarding long-term functional outcomes after MHI justifies the routine use of CT in all patients with these injuries.