The Neurotraumatology Committee of the World Federation of Neurosurgical Societies (NCWFS) developed criteria for identifying mild head injury in an adult. This can help identify patients who may require a more careful evaluation and closer monitoring.
Inclusion criteria: patient >= 10 years of age with minor, mild or trivial head injury
Exclusion criteria: Glasgow coma score <= 13
Adverse outcome measures:
(1) post-traumatic lesion
(2) need for neurosurgical intervention
(3) severe disability at 6 months
(4) permanent vegetative state at 6 months
(5) death
Parameters:
(1) Glasgow coma score (GCS)
(2) presence of clinical findings
(3) presence of neurological deficits
(4) evidence of skull fracture
(5) presence of risk factors
Clinical findings - one or more of the following:
(1) amnesia
(2) diffuse headache
(3) vomiting
(4) loss of consciousness
Risk factors - one or more of the following:
(1) presence of a coagulopathy (including anticoagulation therapy)
(2) age > 60 years
(3) history of previous neurosurgery
(4) pre-trauma epilepsy
(5) alcohol and/or drug abuse
|
Parameter |
Low Risk Group |
Intermediate Risk |
High Risk |
|
GCS |
15 |
15 |
14 or 15 |
|
clinical findings |
no |
yes |
variable |
|
neurodeficits |
no |
no |
variable |
|
skull fracture |
no |
no |
variable |
|
risk factors |
no |
no |
variable |
after Table 1, page 411
|
Risk Group |
Imaging Studies |
Disposition |
|
low |
none |
home |
|
intermediate |
CT scan or skull X-ray |
observe in hospital, then home observation |
|
high |
CT scan |
admit to hospital for 24-48 hours, then home observation |
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Otolaryngology
ICD-10: ,
