Utility of head CT in the evaluation of vertigo/dizziness in the emergency department

被引：51

作者：

Lawhn-Heath C. ^{[1
]}

Buckle C. ^{[2
]}

Christoforidis G. ^{[2
]}

Straus C. ^{[2
]}

机构：

[1] University of Chicago, Pritzker School of Medicine, Chicago, IL 60637

[2] University of Chicago Medical Center, Chicago, IL

来源：

Emergency Radiology | 2013年 / 20卷 / 1期

关键词：

CT; Dizziness; Emergency department; Utilization; Vertigo;

D O I：

10.1007/s10140-012-1071-y

中图分类号：

学科分类号：

摘要：

Acute dizziness (including vertigo) is a common reason to visit the emergency room, and imaging with head CT is often performed initially to exclude a central cause. In this study, consecutive patients presenting with dizziness and undergoing head CT were retrospectively reviewed to determine diagnostic yield. Four hundred forty-eight consecutive head CTs in a representative sample of dizzy emergency room (ER) patients, including patients with other neurological symptoms, were reviewed to identify an acute or subacute cause for acute dizziness along with the frequency and modalities used in follow-up imaging. The diagnostic yield for head CT ordered in the ER for acute dizziness is low (2.2 %; 1.6 % for emergent findings), but MRI changes the diagnosis up to 16 % of the time, acutely in 8 % of cases. Consistent with the American College of Radiology appropriateness criteria and the literature, this study suggests a low diagnostic yield for CT in the evaluation of acute dizziness but an important role for MRI in appropriately selected cases. © 2012 Am Soc Emergency Radiol.

引用

页码：45 / 49

页数：4

共 11 条

[1] Kerber K.A., Brown D.L., Lisabeth L.D., Smith M.A., Morgenstern L.B., Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: A population-based study, Stroke, 37, 10, pp. 2484-2487, (2006)
[2] Chase M., Joyce N.R., Carney E., Et al., ED patients with vertigo: Can we identify clinical factors associated with acute stroke?, Am J Emerg Med, 30, 4, pp. 587-591, (2011)
[3] Kroenke K., Hoffman R.M., Einstadter D., How common are various causes of dizziness? A critical review, South Med J, 93, (2000)
[4] Seemungal B.M., Bronstein A.M., A practical approach to acute vertigo, Pract Neurol, 8, (2008)
[5] Kim A.S., Sidney S., Klingman J.G., Et al., Practice variation in neuroimaging to evaluate dizziness in the ED, Am J Emerg Med, 30, 5, pp. 665-672, (2011)
[6] Wasay M., Dubey N., Bakshi R., Dizziness and yield of emergency head CT scan: Is it cost effective?, Emergency Medicine Journal, 22, 4, (2005)
[7] Chalela J.A., Kidwell C.S., Nentwich L.M., Luby M., Butman J.A., Demchuk A.M., Hill M.D., Patronas N., Latour L., Warach S., Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: A prospective comparison, Lancet, 369, 9558, pp. 293-298, (2007)
[8] Kerber K.A., Vertigo and dizziness in the emergency department, Emerg Med Clin N Am, 27, 1, pp. 39-50, (2007)
[9] Labuguen R.H., Initial evaluation of vertigo, Am Fam Physician, 73, (2006)
[10] Edlow J.A., Newman-Toker D.E., Savitz S.I., Diagnosis and initial management of cerebellar infarction, Lancet Neurol, 7, (2008)

← 1 2 →