Table 2.

Canadian Assessment of CT for Childhood Head injury (CATCH)

CT of the head is required only for children with minor head injury* and any one of the following findings:

High risk (need for neurologic intervention) 1. GCS< 15 at two hours after injury 2. Suspected open or depressed skull fracture 3. History of worsening headache 4. Irritability on examination

Medium risk (brain injury on CT scan) 5. Any sign of basal skull fracture (e.g., hemotympanum, “Raccoon” eyes, otorrhea or rhinorrhea of the cerebrospinal fluid, Battle’s sign) 6. Large, boggy hematoma of the scalp 7. Dangerous mechanism of injury (e.g., motor vehicle crash, fall from elevation ≥ 3 ft [≥ 91 cm] or 5 stairs, fall from bicycle with no helmet)

CT - computed tomography, GCS – Glasgow Coma Scale.

^*Minor head injury is defined as injury within the last 24 hours associated with loss of consciousness, definite amnesia, disorientation, persistent vomiting (more than one episode) or persistent irritability in a child below two years of age with a GCS of 13-15.