🧠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 |
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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.