NICE recommends a CT scan if

• GCS less than 13 at any point since the injury

• GCS equal to 13 or 14 at two hours after the injury.

• Suspected open or depressed skull fracture.

• Any sign of basal skull fracture (haemotympanum, ‘panda’ eyes, cerebrospinal fluid otorrhoea, Battle’s sign).

• Post traumatic seizure.

• Focal neurological deficit.

• More than one episode of vomiting

• Amnesia for greater than 30 minutes of events before impact. ( cannot recall what he/she was doing just before injury/accident)