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The New Orleans Criteria and the Canadian CT Head Rule — two externally validated prediction rules for use of computed tomography (CT) in patients with minor head injury — apply only to patients who have had loss of consciousness. Many patients with minor head injury do not have such a history, but clinicians still must decide whether a CT scan is needed. Dutch investigators used risk factors from studies of the two previous prediction rules to develop a more widely applicable rule.
The researchers prospectively enrolled 3181 patients who presented within 24 hours of blunt head injury and who had a Glasgow Coma Scale score of 13 or 14 or a score of 15 along with at least one risk factor (e.g., vomiting). Head CT performed according to publis…