what are the indications for CT brain in case of a head injury



The indications are not so specifically framed as a protocol, but I think, it can be decided by the casualty or trauma medical officer..
generally,
indications are,
1,presence of any one or more of LOC(loss of consciousness-even upto 5min)/PTA(post or pretraumatic amnesia), vomiting, ENT bleed or CSF leak, fits or seizues,headache.
2,patient received in coma or low GCS(lessthan 14), or altered consciousness,(due to any cause) or progressive worsening of GCS or diffic in assessing GCS
3,penetrating head injury or violent mode of injury with or without skull fractures/tense fontanelles
4,with any of the risk factors-coagulopathy,ch.alcoholism,drugs,epileptic,prev neurosurgery,disabled or elderly or children(even without low GCS or any of previous symptoms,)
note-
-those pts who are ordered an emergency CT need not have a routine skull x ray
-those with trivial head injury without any of above factors can be put in observation for 6-12hrs and CT taken if he deteriorates.
-if discharged, after 12hrs without any deterioratio, then a clear instruction or information sheet is to be given,indicating the need for review if any sequelae or problem arises