Useful Signs and Symptoms of Severe Intracranial Injury After Minor Head Trauma


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Am Fam Physician. 2016 Apr 1;93(7):594a-596.

Clinical Question

Which clinical signs and symptoms are useful in accurately diagnosing a severe intracranial injury after minor head trauma in adults?

Bottom Line

Specific individual risk factors, clinical signs, and symptoms are useful in identifying adults with minor head trauma who are at risk of severe intracranial injury. The absence of all features of the Canadian CT Head Rule and New Orleans Criteria is also highly accurate for identifying adults at low risk of severe injury. (Level of Evidence = 1b)


Adults who appear well and have a Glasgow Coma Scale (GCS) score of 13 or higher after traumatic brain injury are defined as having minor head trauma. These investigators searched Medline and the Cochrane Library, as well as pertinent references from retrieved articles, for English-language studies of adults (18 years or older) with head trauma who presented for evaluation with GCS

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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Oct 15, 2016

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