New Orleans Head CT Criteria
A main issue with New Orleans is that the specificity is so low that what we see is increased testing when you use this rule. The Canadian CT rule has a considerably higher specificity and you only miss CT findings that don’t need neurosurgical intervention. These findings don’t really matter . . . except, possibly to a plaintiff’s lawyer - Anand Swaminathan MD and Emily J Junck MD
HWN Suggests
Clinical Decision Instruments in Minor Head Trauma – New Orleans + Canadian Decision Instruments
The New Orleans head CT criteria allow clinicians to identify all patients who will have intracranial injuries whether they are clinically significant or not but is unlikely to produce anything more than very small reductions in CT utilization. The Canadian Head CT decision instrument is a highly sensitive tool for determining which patients with minor head injury do not need emergent advanced imaging performed.
Featured
New Orleans Head CT Criteria
Guidelines for performing head CT scans to assess traumatic brain injury and determine the need for neurosurgical intervention.
Articles of Interest
Accuracy of Canadian CT Head Rule and New Orleans Criteria for Minor Head Trauma; a Systematic Review and Meta-Analysis
The present meta-analysis demonstrated that both CCHR and NOC scores have a good predictive value in predicting the presence of abnormal findings in CT scan and ciTBI. The similar performance of CCHR and NOC models results in their interchangeable use in cases of contraindication.
Canadian CT Head Rule Is Superior to New Orleans Criteria in Minor Head Injury
In patients with Glasgow Coma Scale scores of 15, both decision rules had 100% sensitivity for identifying significant intracranial injuries, but the Canadian CT Head Rule had higher specificity.
Canadian CT Head Rules Better than New Orleans Rules
In a head-to-head contest between the New Orleans Criteria (NOC) and the Canadian Computed Tomography (CT) Head Rules (CCHR), the Canadian rules showed higher sensitivity and specificity in predicting neurosurgical intervention for mild head injury.
Comparison of the Canadian CT head rule and the new orleans criteria in patients with minor head injury
The CCHR has higher specificity, PPV and NPV for important clinical outcomes than does the NOC.
Computed Tomography for Minor Head Injury: The New Orleans Criteria
The study showed that head CT scans for patients with minor head injury can be safely limited to those presenting with at least 1 of 7 specific clinical findings. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.
The Applicability of New Orleans Criteria for Head Computed Tomography in Inpatient Falls With Injury
Our findings show that use of the NOC to evaluate potential intracranial injury in inpatient falls is limited. Adding criteria to the NOC may improve its test characteristics, with a sensitivity of 100% for the NOC or coagulopathy, suggesting potential clinical utility.
Resources
New Orleans/Charity Head Trauma/Injury Rule
Criteria for which patients are unlikely to require imaging after head trauma.
Core EM
This study derived and prospectively validated a clinical decision instrument with a very high sensitivity and very poor specificity. Unlike the Canadian Head CT instrument, it identifies ALL intracranial injuries regardless of whether they are clinically significant or not. The low specificity limits the utility of this instrument.
