ToolsCalculators
PECARN pediatric head-injury algorithm
Stratifies risk of clinically important TBI after minor head trauma.
PECARN pediatric head-injury algorithm
Age group
GCS ≤ 14, altered mental status, or signs of altered mental status
Palpable skull fracture (< 2 y) or signs of basilar skull fracture (≥ 2 y)
Occipital/parietal/temporal scalp haematoma (< 2 y only)
Loss of consciousness (≥ 5 s if < 2 y; any if ≥ 2 y)
Vomiting (≥ 2 y only)
Severe headache (≥ 2 y only)
Severe injury mechanism
Not acting normally per parent (< 2 y only)
ResultVery low risk
No predictors present — ciTBI risk < 0.05%; CT is not recommended.
- ciTBI risk
- < 0.05%
When to use
- Deciding on CT head in children under 18 with minor blunt head trauma (GCS 14–15).
Formula
High risk if GCS ≤ 14 / altered mental status / (palpable skull fracture < 2 y, basilar skull fracture ≥ 2 y). Otherwise intermediate if any age-specific predictor present; otherwise very low risk.
Pearls and pitfalls
- Applies to GCS 14–15 within 24 h of injury; does not replace clinical judgement.