Imaging recommendation · Neuro · Head & Neck

Head trauma with GCS ≤ 14 or loss of consciousness

Q: What's the alternative imaging for head trauma with gcs ≤ 14 or loss of consciousness when pediatric, low-risk per pecarn?

Observation, no imaging (no contrast).

Recommended: CT Head without contrast is the preferred imaging study for head trauma with gcs ≤ 14 or loss of consciousness. Apply Canadian CT Head Rule.

Recommended study

CT Head without contrast

CT No contrast Preferred Neuro · Head & Neck Emergency Reviewed 2026-03

Apply Canadian CT Head Rule. Repeat at 6-24 h only for clinical deterioration or anticoagulation.

If the default doesn't apply

Pediatric, low-risk per PECARN

Observation, no imaging No contrast

Watch-outs

Anticoagulated patients

Lower threshold for imaging, and consider repeat at 6 h even if initial normal.

Pearls

Coup-contrecoup contusions take hours to declare — repeat CT if clinical change.