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Repeat head CT scan

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https://www.readbyqxmd.com/read/29766124/routine-repeat-head-ct-may-not-be-necessary-for-patients-with-mild-tbi
#1
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Background: Routine repeat cranial CT (RHCT) is standard of care for CT-verified traumatic brain injury (TBI). Despite mixed evidence, those with mild TBI are subject to radiation and expense from serial CT scans. Thus, we investigated the necessity and utility of RHCT for patients with mild TBI. We hypothesized that repeat head CT in these patients would not alter patient care or outcomes. Methods: We retrospectively studied patients suffering from mild TBI (Glasgow Coma Scale (GCS) score 13-15) and treated at the R Adams Cowley Shock Trauma Center from November 2014 through January 2015...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29603477/challenges-and-limitations-in-the-diagnosis-of-atrio-esophageal-fistula
#2
Francis J Ha, Hui-Chen Han, Prashanthan Sanders, Andrew W Teh, David O'Donnell, Omar Farouque, Han S Lim
INTRODUCTION: Atrio-esophageal fistula (AEF) is a dire complication of atrial fibrillation ablation. The diagnostic yield of computed tomography (CT) chest, the role and timing of repeat testing, and the value of other investigations in the diagnosis of AEF is uncertain. METHODS: We systematically reviewed published AEF cases to evaluate radiological, bedside and biochemical investigations for AEF (registered on PROSPERO [CRD42017077493]). RESULTS: Eighty-seven articles with 126 patients (median age, 59 years; male, 71%) were included in the analysis...
March 30, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29549483/the-transgluteal-approach-to-shockwave-lithotripsy-to-treat-distal-ureter-stones-a-prospective-randomized-and-multicenter-study
#3
Min Soo Choo, Jun Hyun Han, Jong Keun Kim, Tae Young Shin, Won Ki Lee, Sang Kon Lee, Seong Ho Lee
PURPOSE: We compared the outcomes of SWL to treat distal ureter stones with regard to the conventional prone and supine positions using the transgluteal approach through the greater sciatic foramen. METHODS: A prospective, randomized, single-blind, and multicenter study was conducted between October 2014 and July 2015. The inclusion criteria were radio-opaque distal ureter stones with a maximum diameter of 0.5-2 cm as measured on a CT scan. The included 160 patients were randomly assigned to two groups: the prone group (n = 80; treated in the conventional prone position) and the transgluteal group (n = 80; treated in the supine position using a transgluteal approach)...
March 16, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29496726/utility-of-repeat-head-ct-in-patients-with-blunt-traumatic-brain-injury-presenting-with-small-isolated-falcine-or-tentorial-subdural-hematomas
#4
K K Devulapalli, J F Talbott, J Narvid, A Gean, B Rehani, G Manley, A Uzelac, E Yuh, M C Huang
BACKGROUND AND PURPOSE: In blunt traumatic brain injury with isolated falcotentorial subdural hematoma not amenable to neurosurgical intervention, the routinely performed, nonvalidated practice of serial head CT scans frequently necessitates increased hospital resources and exposure to ionizing radiation. The study goal was to evaluate clinical and imaging features of isolated falcotentorial subdural hematoma at presentation and short-term follow-up. MATERIALS AND METHODS: We performed a retrospective analysis of patients presenting to a level 1 trauma center from January 2013 to March 2015 undergoing initial and short-term follow-up CT with initial findings positive for isolated subdural hematoma along the falx and/or tentorium...
April 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29472093/image-quality-for-radiotherapy-ct-simulators-with-different-scanner-bore-size
#5
Nada Tomic, Pavlos Papaconstadopoulos, Saad Aldelaijan, Juha Rajala, Jan Seuntjens, Slobodan Devic
PURPOSE: We compare image quality parameters derived from phantom images taken on three commercially available radiotherapy CT simulators. To make an unbiased evaluation, we assured images were obtained with the same surface dose measured using XR-QA2 model GafChromic™ film placed at the imaging phantom surface for all three CT-simulators. METHODS: Radiotherapy CT simulators GE LS 16, Philips Brilliance Big Bore, and Toshiba Aquilion LB were compared in terms of spatial resolution, low contrast detectability, image uniformity, and contrast to noise ratio using CATPHAN-504 phantom, scanned with Head and Pelvis protocols...
January 2018: Physica Medica: PM
https://www.readbyqxmd.com/read/29435816/rapid-and-reliable-detection-of-previous-freezing-of-cerebral-tissue-by-computed-tomography-and-magnetic-resonance-imaging
#6
Stephan A Bolliger, Doris Tomasin, Jakob Heimer, Henning Richter, Michael J Thali, Dominic Gascho
Due to slowing or even inhibition of postmortem processes, freezing may make an estimation of the time-since-death very difficult. This is also true in previously frozen and subsequently thawed bodies. Knowledge of prior freezing is important, as it may lead to a different assessment of the time since death. Twelve pig heads were frozen at -20 °C, and 6 heads were either kept at room temperature (approximately 20 °C) or in a cooling cell (approximately 5 °C). The frozen brains and cadavers were thawed at either room temperature or in a cooling cell...
March 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29423769/repeat-computed-tomography-scans-among-inter-facility-transferred-major-trauma-patients-in-oklahoma-2009-2015
#7
Yang Wan, Kenneth E Stewart, Martin Q Lansdale
PURPOSE: Computed tomography (CT) scans play a vital role in the diagnosis and evaluation of trauma patients. Repeat CT scans occurred often among transferred trauma patients. The objective was to describe CT use and identify patient- and hospital-level factors associated with repeat CT scans among inter-facility transferred major trauma patients. METHODS: A retrospective cohort study was conducted using data extracted from the Oklahoma State Trauma Registry between 2009 and 2015...
February 8, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29373665/insights-into-radiographic-investigations-for-headaches-in-general-practice
#8
Chris O Ifediora
Background/Objective: Headaches present commonly in general practice, and doctors face uncertainties and pressures in dealing with them. This study identifies key characteristics of headaches investigated through head imaging, in the hope of strengthening existing guidelines. Method: A 7-year retrospective analysis of head imaging scans ordered for investigating headaches among patients aged ≥18 in an Australian general practice setting. Results: A total of 109 of the 517 (21...
January 24, 2018: Family Practice
https://www.readbyqxmd.com/read/29336817/neurocognitive-assessment-in-patients-with-a-minor-traumatic-brain-injury-and-an-abnormal-initial-ct-scan-can-cognitive-evaluation-assist-in-identifying-patients-who-require-surveillance-ct-brain-imaging
#9
Thomas W Clements, Michael Dunham, Andrew Kirkpatrick, Ruphus Rajakumar, Carolyn Gratton, Rohan Lall, Paul McBeth, Chad G Ball
BACKGROUND: Evidence for repeat computed tomography (CT) in minor traumatic brain injury (mTBI) patients with intracranial pathology is scarce. The aim of this study was to investigate the utility of clinical cognitive assessment (COG) in defining the need for repeat imaging. METHODS: COG performance was compared with findings on subsequent CT, and need for neurosurgery in mTBI patients (GCS 13-15 and positive CT findings). RESULTS: Of 152 patients, 65...
January 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29313360/diagnostic-bone-imaging-in-patients-with-prostate-cancer-patient-experience-and-acceptance-of-naf-pet-ct-choline-pet-ct-whole-body-mri-and-bone-spect-ct
#10
Eva Dyrberg, Emil L Larsen, Helle W Hendel, Henrik S Thomsen
Background Patient acceptance is an important factor when implementing imaging methods in clinical practice in line with availability, diagnostic accuracy, and cost-effectiveness. Purpose To investigate patient experience and acceptance regarding18F-sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT), 11 C-choline-PET/CT, whole-body magnetic resonance imaging (WB-MRI), and 99mTc-hydroxymethane diphosphonate (HDP) single photon emission/computed tomography (SPECT/CT). Material and Methods One hundred and forty-nine patients with prostate cancer filled in a questionnaire regarding their experience of the imaging procedures they had been undergoing as part of a diagnostic accuracy study...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29250024/clinical-predictors-of-progressive-hemorrhagic-injury-in-children-with-mild-traumatic-brain-injury
#11
Guangfu Di, Hua Liu, Xiaochun Jiang, Yi Dai, Sansong Chen, Zhichun Wang, Hongyi Liu
Objective: Traumatic brain injury (TBI) occurs commonly in children. Repeat computed tomography (CT) follow up of TBI patients is often scheduled to identify progressive hemorrhagic injury (PHI). However, the utility of repeated CT scans, especially in children with mild TBI [Glasgow Coma Scale (GCS) scores of 13-15], has been debated. The purposes of the present study were to identify clinical predictors of PHI in children with mild TBI and to clarify relevant clinical factors via radiological examination...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29188151/arachnoid-cyst-and-psychosis
#12
Afaque H Khan, Syed E Ahmed
Few case reports discuss suspected psychiatric disturbances secondary to arachnoid cysts. To the best of our knowledge, psychosis from arachnoid cysts has not been reported in the recent literature. This case report discusses our experience with a 55-year-old male patient who manifested multiple psychotic episodes suspected in association with an arachnoid cyst. During the initial examinations, a computed tomography (CT) scan of his head revealed a relatively large left anterior superior arachnoid cyst with a mass effect on the frontal lobe...
September 21, 2017: Curēus
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#13
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the institutional review board. Study subjects were patients ≥ 18 years of age with an International Classification of Diseases code corresponding to a traumatic ICH and admitted to an ED observation unit (EDOU) of an urban, academic Level I trauma center between February 1, 2015, and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29122307/role-of-serial-ultrasonic-optic-nerve-sheath-diameter-monitoring-in-head-injury
#14
A K Thotakura, N R Marabathina, A R Danaboyina, R R Mareddy
OBJECTIVES: To compare optic nerve sheath diameter (ONSD) measurements in head injury patients with a group of normal subjects and investigate the significance of serial ONSD monitoring in head injury patients. METHODS: All patients with a head injury admitted to our hospital with a program of conservative management at the time of admission were included in this prospective study. On admission, the patient was assessed using the Glasgow Coma Scale (GCS), orbital ultrasound for optic nerve sheath diameter (ONSD), and CT brain scan...
December 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29105542/cervical-necrotizing-fasciitis-an-overlooked-diagnosis-of-a-fatal-disease
#15
Mohamed A Al-Ali, Ashraf F Hefny, Kamal M Idris, Fikri M Abu-Zidan
BACKGROUND: Necrotizing fasciitis of the neck is a rare potentially lethal condition if not early diagnosed and managed. We aimed to study the clinical presentation, radiological and microbiological diagnosis, management, and surgical outcome of patients having cervical necrotizing fasciitis (CNF). MATERIALS AND METHODS: We retrospectively studied patients having a final diagnosis of CNF who were treated at Al Ain Hospital during the period of January 2000 to December 2016...
April 2018: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/29104682/the-necessity-of-follow-up-brain-computed-tomography-scans-is-it-the-pathology-itself-or-our-fear-that-we-should-overcome
#16
Ahmet Öğrenci, Orkun Koban, Murat Ekşi, Onur Yaman, Sedat Dalbayrak
AIM: This study aimed to make a retrospective analysis of pediatric patients with head traumas that were admitted to one hospital setting and to make an analysis of the patients for whom follow-up CT scans were obtained. METHODS: Pediatric head trauma cases were retrospectively retrieved from the hospital's electronic database. Patients' charts, CT scans and surgical notes were evaluated by one of the authors. Repeat CT scans for operated patients were excluded from the total number of repeat CT scans...
October 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29100783/factors-associated-with-imaging-overuse-in-the-emergency-department-a-systematic-review
#17
REVIEW
Monica Tung, Ritu Sharma, Jeremiah S Hinson, Stephanie Nothelle, Jean Pannikottu, Jodi B Segal
BACKGROUND: Emergency departments (ED) are sites of prevalent imaging overuse; however, determinants that drive imaging in this setting are not well-characterized. We systematically reviewed the literature to summarize the determinants of imaging overuse in the ED. METHODS: We searched MEDLINE® and Embase® from January 1998 to March 2017. Studies were included if they were written in English, contained original data, pertained to a U.S. population, and identified a determinant associated with overuse of imaging in the ED...
February 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29075831/repeatability-of-tumour-hypoxia-imaging-using-18-f-ef5-pet-ct-in-head-and-neck-cancer
#18
Antti Silvoniemi, Sami Suilamo, Timo Laitinen, Sarita Forsback, Eliisa Löyttyniemi, Samuli Vaittinen, Virva Saunavaara, Olof Solin, Tove J Grönroos, Heikki Minn
PURPOSE: Hypoxia contributes to radiotherapy resistance and more aggressive behaviour of several types of cancer. This study was designed to evaluate the repeatability of intratumour uptake of the hypoxia tracer [18 F]EF5 in paired PET/CT scans. METHODS: Ten patients with newly diagnosed head and neck cancer (HNC) received three static PET/CT scans before chemoradiotherapy: two with [18 F]EF5 a median of 7 days apart and one with [18 F]FDG. Metabolically active primary tumour volumes were defined in [18 F]FDG images and transferred to co-registered [18 F]EF5 images for repeatability analysis...
February 2018: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28991942/confusion-recurs-2-weeks-after-fall
#19
Nick Koneri, Andrew Muck, Bruce D Adams
A 77-year-old woman presented to the emergency department complaining of a headache following a syncopal episode (while standing) earlier that day. She said that she'd lost consciousness for several minutes, and then experienced several minutes of mild confusion that resolved spontaneously. On physical exam, she was oriented to person and place, but not time. She had a contusion in her left occipitoparietal region without extensive bruising or deformity. The patient had normal cardiopulmonary, abdominal, and neurologic exams...
October 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28988732/rupture-of-an-occult-intracranial-mycotic-aneurysm-after-intravenous-thrombolysis-with-recombinant-tissue-plasminogen-activator-for-acute-ischemic-stroke
#20
Jared Glenn, Margaret Strecker-McGraw, Ian McGraw, Karim Jabbar, Nathan A James, C Keith Stone
BACKGROUND: The treatment of acute ischemic stroke with recombinant tissue plasminogen activator (rtPA) has become the mainstay of treatment, but its use carries a risk of subsequent intracranial hemorrhage (ICH). Guidelines have been developed to aid in the selection of the appropriate candidates to treat with rtPA to reduce this risk. We present a case of a stroke patient who was an appropriate candidate and was treated with rtPA who experienced a fatal subarachnoid hemorrhage due to a ruptured mycotic aneurysm (MA)...
November 2017: Journal of Emergency Medicine
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