Canadian CT Head Rule

Determines which minor head injury patients need head CT imaging.

Canadian CT Head Rule Calculator

Clinical decision support for CT imaging in eligible patients with minor head injury.

Patient Assessment

Complete all fields to determine whether the Canadian CT Head Rule indicates CT imaging.

Use only for eligible patients: age 16 years or older, blunt head injury within 24 hours, initial GCS 13–15, and witnessed loss of consciousness, definite amnesia, or witnessed disorientation. This rule should not be used when exclusion criteria apply.
Eligibility for the Canadian CT Head Rule

Does the patient meet the entry criteria above and have no major exclusion such as focal neurological deficit, seizure before assessment, bleeding disorder/anticoagulant use, pregnancy, obvious penetrating skull injury, or major trauma requiring resuscitation?

1. GCS score at 2 hours after injury

Is the GCS score less than 15 at 2 hours after injury?

2. Suspected open or depressed skull fracture

Are there clinical signs of an open or depressed skull fracture?

3. Signs of basal skull fracture

Examples include hemotympanum, raccoon eyes, Battle’s sign, or CSF otorrhoea/rhinorrhoea.

4. Vomiting episodes

Has the patient had two or more episodes of vomiting?

5. Age

Is the patient 65 years of age or older?

6. Amnesia before impact

Is there more than 30 minutes of amnesia before impact?

7. Dangerous mechanism of injury

Pedestrian struck by a motor vehicle, occupant ejected from a motor vehicle, or fall from elevation greater than 3 feet / 5 stairs.

About the Canadian CT Head Rule

The Canadian CT Head Rule helps identify eligible patients with minor head injury who may require CT imaging. It contains five high-risk criteria for neurosurgical intervention and two medium-risk criteria for clinically important brain injury on CT.

This calculator is clinical decision support only and does not replace clinical judgement, local imaging pathways, observation, or emergency assessment.

References

Stiell IG, Wells GA, Vandemheen K, et al. The Canadian CT Head Rule for patients with minor head injury. Lancet. 2001;357(9266):1391–1396.

Stiell IG, Clement CM, Rowe BH, et al. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. JAMA. 2005;294(12):1511–1518.

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