Covino M, et al. - Researchers sought to propose an easy clinical score that may assist in assessing the necessity for cranial computed tomography (CCT) in emergency department (ED) patients with suspect non-traumatic intracranial pathology. Clinical data of 1156 patients presenting to the ED for neurological deficit, postural instability, acute headache, altered mental status, seizures, confusion, dizziness, vertigo, syncope, or pre-syncope were retrospectively evaluated. They used a logistic regression model on clinical factors significant at univariate analysis to built the score for positive CCT prediction. These patients had CCT Positivity of 15.2%. Independent predictors of positive CCT were a persistent neurological deficit, new onset acute headache, seizures and/or altered state of consciousness, and transient neurological disorders. In a validation prospective cohort, 508 patients were observed with CCT positive in 11.3%. The score performed well with a receiver operating characteristic area under curve of 0.787 in the validation population. As per observations, CT request in ED could be reduced using the score for risk stratification of patients with suspect of intra-cranial pathology, avoiding a significant number of CCT while reducing the risk of missing positive results.