Indications for CT scanning in minor head injuries: A review

BACKGROUND AND OBJECTIVE: To determine indications for performing head CT following minor head injuries, which allow reducing number of imaging. MATERIALS AND METHODS: Based on 15 articles dedicated to this topic, the clinical decision rules were systematically analysed. RESULTS: The Canadian Computed Tomography Head Rule was found to be the most reliable instrument meeting these criteria, characterised by excellent sensitivity of 100% and fairly good specificity of 48-77%. Remaining scales, although very sensitive, showed poor ability to reduce number of "unnecessary" CT scans. Features most predictive for intracranial injuries included: disorientation, abnormal alertness, somnolentia and neurological deficits. Patients with no loss of consciousness and in normal physical condition need only clinical assessment. Indications to head CT scanning are determined by decision rules presented in the article. CONCLUSION: Use of clinical decision rules may have effect on reducing number of head CT scanning performed "just in a case".