Assessment, investigation, and early management of head injury: summary of NICE guidance

Head injury is a major public health problem both logistically and clinically. Many patients seek healthcare advice for this, although relatively few will need care in a neuroscience centre. Most will make a good recovery, but the incidence of ensuing disability even after apparently “minor” injury is surprisingly high. This article summarises the most recent guidance update from the National Institute for Health and Clinical Excellence (NICE) on the appropriate investigation and early care of patients with head injury, where there has been a significant shift from “admit and observe” to “diagnose and decide.”1 NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, a range of consensus techniques is used to develop recommendations. In this summary, recommendations derived primarily from consensus techniques are indicated with an asterisk (*). ### CT imaging of the head in adults Request computed tomography (CT) brain scan immediately for adult patients with any of the following risk factors: ### CT imaging of the head in children Request computed tomography of the brain immediately for children with any one of the following risk factors: