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The previous head injury guideline produced by NICE in 2003 (NICE clinical guideline 4) and updated in 2007 (NICE clinical guideline 56) resulted in CT scanning replacing skull radiography as the primary imaging modality for assessing head injury. It also led to an increase in the proportion of people with severe head injury having their care managed in specialist centres. This has been associated with a decline in fatality among patients with severe head injury. This update is needed because of the continuing importance of up-to-date evidence-based guidance on the initial assessment and early management of head injury. Appropriate guidance can enable early detection and treatment of life-threatening brain injury, where present, but also early discharge of patients with negligible risk of brain injury. It can therefore save lives while at the same time preventing needless crowding in emergency departments and observation wards.

Over a year has passed but the pointed scar on Danish Saifi's forehead remains a repeated reminder of the fateful night when an angry mob, constituted largely of his neighbours in Bishahra dragged his family out of their house, broken his skull and lynched his father Mohammad Akhlaq Saifi over suspicions that they slaughtered a cow and ate beef.