Canadian CT Head Rule
Identifies adults with minor head injury (GCS 13–15) who require CT head to detect clinically important brain injury or skull fracture. Applicable to patients with witnessed LOC, amnesia, or confusion.
Score interpretation
No high or medium risk factors. Clinically important brain injury very unlikely.
→ CT head not indicated. Discharge with head injury advice. Return if: persistent headache, vomiting, drowsiness, focal neurology, seizure, confusion.
Medium risk factors present. CT head recommended to exclude haematoma or skull fracture.
→ CT head. If normal: discharge with head injury advice. If abnormal: neurosurgery referral.
High risk factors present. Significant risk of injury requiring neurosurgical intervention.
→ Urgent CT head. Neurosurgery review. Airway assessment. Serial GCS. If deteriorating: anaesthetics / ITU.
Interpretation bands for the Canadian CT Head. Apply clinical judgement and local guidance.
References
- Stiell IG, et al. The Canadian CT Head Rule for patients with minor head injury. Lancet. 2001;357(9266):1391–1396.
Related
Curated clinical cross-links plus same-class fallbacks.
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Pembrolizumab (Head and Neck SCC) · PD-1 Inhibitor
- Nivolumab (Head and Neck SCC) · PD-1 Inhibitor
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.