Head CT (Peds)

< 2 yr old

no CT if all below negative

1. AMS
2. Scalp hematoma (parietal, occipital, temporal, excluding frontal)
3. LOC > 5sec
4. Severe mechanism of injury
5. Palpable or unclear skull fracture
6. Acting normal per parent

> 2 yr old

no CT if all below negative

1. AMS
2. LOC
3. History of vomiting
4. Severe mechanism of injury
5. Clinical signs of basilar skull fracture
6. Severe headache

NPV > 99% PPV > 99%

Treatment

If any (except AMS or e/o fracture) are positive, may consider period of observation vs CT depending on:

1. Physician experience
2. Parental preference

See Also

Peds: Head Trauma (Peds)

Peds: GCS (Peds)

Peds: Concussion

Peds: Skull Fracture

Peds: Abuse (Nonaccidental Trauma)

Trauma: Head Trauma (Adult)

Source

PECARN- Kupperman 2009