Canadian CT Head Rule
Ausschluss klinisch relevanter Hirnverletzungen bei Erwachsenen mit leichtem Schädel-Hirn-Trauma (GCS 13–15). Reduziert unnötige CT-Untersuchungen.
Einschlusskriterien
Patient muss ≥ 16 Jahre alt sein, stumpfes Schädel-Hirn-Trauma mit bezeugtem Bewusstseinsverlust, Amnesie oder Verwirrtheit aufweisen, und GCS 13–15.
Ausschlüsse: Antikoagulanzien, Blutungsneigung, offene Schädelfraktur, Alter < 16.
Hochrisikofaktoren (CT erforderlich)
Mittlere Risikofaktoren (CT erwägen)
Disclaimer: Nur für Bildungszwecke. Kein Ersatz für klinische Beurteilung.
Über dieses Tool
Was ist die Canadian CT Head Rule?
The Canadian CT Head Rule (CCHR) is a highly validated clinical decision rule developed to identify patients with minor head injury who do NOT need a CT scan. It aims to reduce unnecessary radiation exposure and resource use while missing zero neurosurgical cases.
Validierung
In the original study (Stiell et al., Lancet 2001), the rule was 100% sensitive for predicting need for neurosurgical intervention and clinically important brain injury. It is widely considered superior to the New Orleans Criteria for specificity (reducing scans).
🔑 Klinische Hinweise
- "Clinically important brain injury" is defined as any acute finding on CT that would require admission or neurosurgical follow-up.
- Dangerous mechanism includes: pedestrian struck by vehicle, occupant ejected from vehicle, fall from > 3 feet (or > 5 stairs).
- Retrograde amnesia refers to forgetting events BEFORE the injury (anterograde is after).
- Elderly patients (≥ 65) automatically qualify for a scan under this rule due to higher risk of subdural hematoma.
Formel zuletzt überprüft: Februar 2026