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

Purpose: 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.

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

Inclusion Criteria:

Age ≥ 18 years
GCS = 15
Blunt (non-penetrating) head trauma
Presentation within 24 hours of injury

Performance:

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>

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.