Last reviewed: April 2018
Last updated: May  2018

PECARN head injury decision rule has high sensitivity for identifying children with clinically important traumatic brain injury

An observational study of 20,137 children attending emergency departments with head injury found that the PECARN head injury decision rule had 99% point validation sensitivity to detect clinically important traumatic brain injury in children aged 2 years or older and 100% sensitivity in those under 2 years.

The study also confirmed high sensitivity rates for two alternative head injury decision rules in children: the CATCH rule for identifying the need for neurological intervention and the CHALICE rule for detecting clinically significant intracranial injury.

See Diagnosis: approach

Original source of update




  • Skull fracture (excl. base of skull)
  • Base of skull fracture
  • Cerebral contusion
  • Intracerebral haemorrhage (ICH)
  • Subdural haematoma (SDH)
  • Epidural haematoma (EDH)
  • Intraventricular haemorrhage (IVH)
  • Traumatic subarachnoid haemorrhage (SAH)
  • Penetrating injuries
  • Diffuse axonal injury (DAI)
  • Mild traumatic brain injury (mTBI)


Authors VIEW ALL

Albert J. Lauro Professor of Medicine/Emergency Medicine

Clinical Professor Medicine/Emergency Medicine

Director of Education

Section of Emergency Medicine

Louisiana State University Health Science Center

New Orleans



MJH is an author of a reference cited in this monograph.

Dr Micelle J. Haydel would like to gratefully acknowledge Dr Victoria E. Johnson, Dr Marek Ma, Dr Nathan Ranalli, and Dr Douglas H. Smith, previous contributors to this monograph. VEJ, MM, NR, and DHS declare that they have no competing interests.

Peer reviewers VIEW ALL

Director of Research

Department of Emergency Medicine

Emory University




DWW declares that he has no competing interests.

Senior Lecturer In Neurology

Imperial College




DS declares that he has no competing interests.

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