Trauma / Neurosurgery
NICE NG232 Head Injury Assessment
Step-by-step decision algorithms from NICE NG232 for CT head scan and cervical spine imaging in adults and children presenting with head injury.
CT Head Scan — Adults (16+)
Answer each question sequentially. The algorithm will guide you to the correct imaging decision.
1
Are any of these HIGH-RISK factors present?
- GCS score of 12 or less on initial assessment in ED
- GCS less than 15 at 2 hours after injury on assessment in ED
- Suspected open or depressed skull fracture
- Any sign of basal skull fracture (haemotympanum, panda eyes, CSF leak from ear or nose, Battle's sign)
- Post-traumatic seizure
- Focal neurological deficit
- More than 1 episode of vomiting
Based on NICE NG232 (2023). Enhanced with clinical pearls by Dr Sumit Mandal. This tool is for educational purposes and clinical decision-support only — it does not replace clinical judgement. Always consider the full clinical picture and local protocols.