🧠 New Orleans Criteria (NOC) for Head CT in Mild Traumatic Brain Injury [Neurosurgery Wiki]

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====== 🧠 New Orleans Criteria (NOC) for Head CT in Mild Traumatic Brain Injury ======

<wrap lo>**Purpose:**</wrap>  
To identify **adult patients with GCS = 15** after **blunt head trauma** who are at risk for **clinically important intracranial injury** and may require a **head CT scan**.

<WRAP info>
**Head CT is recommended if ANY of the following are present:**
  - Headache
  - Vomiting
  - Age > 60 years
  - Drug or alcohol intoxication
  - Persistent anterograde amnesia (short-term memory loss)
  - Visible trauma above the clavicles
  - Seizure
</WRAP>

<wrap hi>**Inclusion Criteria:**</wrap>
  * Age ≥ 18 years  
  * GCS = 15  
  * Blunt (non-penetrating) head trauma  
  * Presentation within 24 hours of injury  

<wrap important>**Performance:**</wrap>  
  * Sensitivity: **~99%** (excellent for ruling out serious injury)  
  * Specificity: **Low** (many false positives → more CT scans)  

<collapse>📊 Comparison with Other Decision Rules

^ Rule         ^ GCS Range ^ Focus                       ^ Sensitivity ^ Specificity ^
| NOC          | 15        | Symptoms + age              | Very high   | Low         |
| CCHR         | 13–15     | Clinical risk features      | High        | Moderate    |
| NEXUS-II     | ≥13       | Broad safety net            | High        | Low         |

</collapse>

<wrap tip>
**Clinical Tip:**  
Use the New Orleans Criteria to be highly conservative when deciding on CT imaging in patients who are alert (GCS 15). Especially helpful in non-specialized or community ED settings.
</wrap>