CT is indicated in the following situations: (CCHR – GCS 13-15) (Level 1 evidence)

• GCS<15 at 2 hours post injury
• Suspected open or depressed skull fracture (based on physical exam)
• Any sign of basilar skull fracture (Battle’s sign, raccoon eyes, hemotympanum, CSF otorrhea or rhinorrhea)
• 2 or more episodes of vomiting
• > 65 years
• Retrograde amnesia of 30 minutes or more
• Dangerous mechanism (car vs, peds, ejected from a car, fall from 3 feet or more or 5 stairs or more)

CT is always indicated in head trauma with GCS < 13

(Source: JAMA, September 28, 2005 Vol. 294 (12), 1511-1518)