Clinical Decision Instruments for CT Scanning in Minor Head Injury

Comparison of Care System and Treatment Approaches for Patients with Traumatic Brain Injury in China versus Europe: A CENTER-TBI Survey Study

“…22 Various prediction rules and guidelines (e.g., the Canadian CT head rule [CCHR] and New Orleans Criteria) have been developed to estimate the risk of intracranial abnormalities in mTBI. 23,24 Besides, these worldwide popular criteria also show high sensitivity and specificity to prevent missing timely neurosurgical intervention and to avoid the overuse of CT in different countries by various studies. [24][25][26][27][28] Although national or local guidelines for cranial CT among patients with mTBI are still absent in China, a study to evaluate the effectiveness of clinical decision rules for CT scanning in Chinese patients with mTBI has indicated high sensitivity and specificity, which indicates applicability of these rules to Chinese patients.…”

“…23,24 Besides, these worldwide popular criteria also show high sensitivity and specificity to prevent missing timely neurosurgical intervention and to avoid the overuse of CT in different countries by various studies. [24][25][26][27][28] Although national or local guidelines for cranial CT among patients with mTBI are still absent in China, a study to evaluate the effectiveness of clinical decision rules for CT scanning in Chinese patients with mTBI has indicated high sensitivity and specificity, which indicates applicability of these rules to Chinese patients. 21 However, our study demonstrated that only 55.6% of centers in China applied guidelines to triage initial head CT for mTBI patients, and their utilization rate was significantly lower than that in European centers.…”

Prediction of intracranial computed tomography findings in patients with minor head injury by using logistic regression

“…The authors of the Canadian CT head rule study argued that small solitary cerebral contusions, small subarachnoid hemorrhages, small subdural hematomas, and isolated pneumocephalus were not clinically important because these lesions typically do not require neurosurgical intervention. 6 The primary outcome measure in the CHIP prediction rule was any traumatic intracranial finding on CT, which included all traumatic neurocranial findings except for isolated linear skull fractures. 19 A secondary outcome measure in the CHIP prediction rule was neurosurgical intervention contingent on the initial CT.…”

Computed Tomography or Not? A Case Report of an Acute Subdural Hematoma Without Any External Head Injury in an Elderly Patient of Advanced Dementia

“…The New Orleans Criteria (NOC), 6 the Canadian CT Head Rule (CCHR,) 7 and the CT in Head Injury Patients Prediction Rule 8 studies have identified predictors to guide the use of head CT scanning in patients with MHI. Other studies have validated the NOC and CCHR studies, 9 but none of them have been widely accepted for use in the United States 10 . These studies show that a head CT scan is indicated in patients aged 60 to 65 and older with MHI.…”