ToolsCalculators
NEXUS Head CT instrument
Selects blunt head trauma patients who can safely forgo head CT.
NEXUS Head CT instrument
Evidence of significant skull fracture
Scalp haematoma
Neurologic deficit
Abnormal level of alertness
Abnormal behaviour
Persistent vomiting
Coagulopathy
Age ≥65 years
ResultHead CT can be omitted
None of the 8 criteria present — low risk of clinically important intracranial injury; head CT can be safely avoided.
- Criteria present
- 0 of 8
When to use
- Blunt head trauma patients of any age in whom head CT is being considered.
Formula
Head CT indicated if any of 8 criteria are present: significant skull fracture, scalp haematoma, neurologic deficit, abnormal alertness, abnormal behaviour, persistent vomiting, coagulopathy, or age ≥65 years.
Pearls and pitfalls
- Patients with any criterion, or any unassessable criterion, are classified high risk and require imaging.
- In the derivation cohort the rule identified 100% of patients needing neurosurgical intervention.