Canadian Head CT Rules: presence of any one of these indicated CTH
High Risk for Neurosurgical Intervention
1. Glasgow Coma Scale score lower than 15 at 2 hours after injury
2. Suspected open or depressed skull fracture
3. Any sign of basal skull fracture *
4. Two or more episodes of vomiting
5. 65 years or older
Medium Risk for Brain Injury Detection by Computed Tomographic Imaging
6. Amnesia before impact of 30 or more minutes
7. Dangerous mechanism **
- Signs of basal skull fracture include hemotympanum, racoon eyes, cerebrospinal fluid, otorrhea or rhinorrhea, Battle’s sign.
- * Dangerous mechanism is a pedestrian struck by a motor vehicle, an occupant ejected from a motor vehicle, or a fall from an elevation of 3 or more feet or 5 stairs.
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