CT Head — Head Injury (children <16)
CTNICE NG232 (May 2023)v2.0 · March 2026
Varies
ED
All imaging requests must be justified by an IR(ME)R practitioner (radiologist or radiographer)Required Assessment Tools
REQUIRED
Paediatric GCS
Paediatric Glasgow Coma Scale — age-appropriate assessment required; use infant-specific thresholds for children under 1 year
Within 1 hour
Within 1 hour— ANY of the following
- GCS <14 on initial assessment (or GCS <15 for infants under 1 year)
- GCS <15 at 2 hours post-injury
- Suspected open or depressed skull fracture or tense fontanelle (infants)
- Any sign of basal skull fracture
- Post-traumatic seizure
- Focal neurological deficit
- For infants under 1 year: bruise, swelling, or laceration >5 cm on the head
- Suspicion of non-accidental injury
Within 8 hours — LOC or amnesia PLUS ANY
Within 8 hoursLoss of consciousness or amnesia since the injury, PLUS ANY of the following
- Abnormal drowsiness
- Three or more discrete vomiting episodes
- Dangerous mechanism: fall >3 m; high-speed RTA; high-speed object impact to head
- Amnesia lasting more than 5 minutes
Notes
Warning
Children <16 apply THESE criteria, not adult criteria
Alert
For suspected NAI, CT head is mandatory for ALL children under 1 year even without neurological signs
Information
Radiation sensitivity is 2–3x higher in children — ALARP principle mandatory
Radiation Dose
CT head effective dose ~2 mSv — increased relative risk in children due to greater radiosensitivity
Paediatric
Criteria differ substantially from adults — do not apply adult thresholds
Change Log
v2.02026-03-08New protocol — paediatric head injury criteria separated from adult protocol