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| ==Diagnosis==
| | #REDIRECT[[Head trauma (main)]] |
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| CT Guidelines
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| Inclusion = 'minor head trauma'
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| AMERICAN HEAD CT RULE
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| *Minor head trauma = brief LOC after event, then GCS of 15
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| *CT indicated for:
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| #Short term memory deficit (more than amnesia to the event; i.e. persistent anterograde amnesia) | |
| #Evidence of trauma above clavicles
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| #Headache
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| #Vomiting
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| #Age > 60yrs
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| #Drug or EtOH intoxication (clinical impression, not by labs)
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| #Seizure post trauma
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| *Coagulopathy (including coumadin)
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| CANADIAN HEAD CT RULE
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| *Minor head trauma = witnessed LOC, definite amnesia, witnessed disorientation w/ GCS 13-15
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| *CT indicated for:
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| #GCS <15 2hrs post accident
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| #Suspected open/depressed skull fx
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| #Any sign of basal skull fracture (hemotympanum, racoon eyes, CSF otorrhea/ rhinnorrhea, Battle's sign)
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| #Vomiting >2 episodes
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| #Age >=65
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| #Amnesia >30 mins pror to impact
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| #Dangerous mechanism (struck by MVA, ejected from MV, fall from height > 3ft or 5 stairs)
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| ==DDx==
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| #DAI
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| #Contusion
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| #Epidural
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| #Subdural
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| #Traumatic SAH
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| #Intracerebral
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| #Concussion
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| ==Treatment==
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| #Head of bed @ 30 degrees
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| #Seizure prophylaxis
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| #Maintain CO2 30-35 if suspect herniation
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| #maintain CPP (MAP-ICP) 40-65
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| #Prevent:
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| ##Hypotension
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| ##Hypoxia
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| ##Anemia
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| ##Hyperthermia
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| ##Coagulopathy
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| ==See Also==
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| Peds: Head Trauma (Peds)
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| ==Source==
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| *(NEJM 7/00, Haydel)
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| *(Lancet 5/01, Stiell)
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| [[Category:Trauma]]
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