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The National Institute for Health and Clinical Excellence (NICE) published clinical guidelines for the management of head injury (NICE HI) in 2003.1 There is only one indication for a skull x ray in an adult. This is where computed tomography (CT) scanning resources are unavailable. Before the publication of NICE HI, patients with a history of trauma and a large tender swelling in the frontal area would have x rays of the skull taken,2 which included a lateral view of the frontal bone. We describe a case with no NICE HI indications for skull x rays or head CT …
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