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Computed tomography head scans prior to lumbar punctures in suspected meningitis.
Internal Medicine Journal 2019 January
BACKGROUND: The literature suggests that certain clinical criteria to determine raised intracranial pressure (ICP) should be met if a patient suspected of meningitis is to undergo a computed tomography (CT) head scan prior to having a lumbar puncture (LP).
AIM: To evaluate whether these criteria were being used by the general medicine department of Auckland City Hospital when requesting CT scans prior to LPs in patients with suspected meningitis.
METHODS: A total of 37 patients admitted under general medicine with suspected meningitis from 1 January to 31 July 2016 were retrospectively audited based on the clinical evidence justifying the decision to do a CT scan prior to a LP.
RESULTS: Only 7 of 24 patients who underwent CT scans had met clinical criteria for raised ICP. There were no abnormalities found on any of the CT scans and approximately two-thirds of these patients had a final diagnosis of viral illness or headache.
CONCLUSION: A large number of patients with suspected meningitis under general medicine at Auckland City Hospital are having CT scans without clinical evidence suggestive of raised ICP.
AIM: To evaluate whether these criteria were being used by the general medicine department of Auckland City Hospital when requesting CT scans prior to LPs in patients with suspected meningitis.
METHODS: A total of 37 patients admitted under general medicine with suspected meningitis from 1 January to 31 July 2016 were retrospectively audited based on the clinical evidence justifying the decision to do a CT scan prior to a LP.
RESULTS: Only 7 of 24 patients who underwent CT scans had met clinical criteria for raised ICP. There were no abnormalities found on any of the CT scans and approximately two-thirds of these patients had a final diagnosis of viral illness or headache.
CONCLUSION: A large number of patients with suspected meningitis under general medicine at Auckland City Hospital are having CT scans without clinical evidence suggestive of raised ICP.
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