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Chapter 2 - Neuroradiology

from Section 1 - Neurologic Examination and Neurodiagnostic Testing

Published online by Cambridge University Press:  10 January 2024

Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

Nearly half of all emergency department (ED) visits in the United States result in some type of imaging study, a large number of which are performed for neurological complaints. Common presenting neurological complaints include headache, weakness, stroke, and trauma. Often the initial study performed for the evaluation of these complaints is an unenhanced computed tomography (CT) of the brain. However, as will be discussed below, certain presentations and clinical history can warrant magnetic resonance imaging (MRI) as a superior first-line imaging test. This chapter seeks to provide guidance in imaging modality selection and to discuss imaging findings in common clinical presentations to the ED. When pertinent, alternative and recommended follow-up studies are also discussed

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Publisher: Cambridge University Press
Print publication year: 2023

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References

ACR. ACR Appropriateness Criteria® low back pain. Available at www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/LowBackPain.pdf. Accessed 25 July 2015.Google Scholar
Albers, GW, Marks, MP, Kemp, S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med 378(8):708718.Google Scholar
American College of Radiology. ACR Appropriateness Criteria®. Available at www.acr.org/ac.Google Scholar
American College of Radiology. ACR-SPR practice parameter for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. 2014. Web.Google Scholar
American College of Radiology. Manual on contrast media V10. 2015. Web.Google Scholar
Aviv, RI, Mandelcorn, J, Chakraborty, S, et al. Alberta Stroke Program early CT scoring of CT perfusion in early stroke visualization and assessment. AJNR Am J Neuroradiol 2007; 28(10):19751980.CrossRefGoogle ScholarPubMed
Goyal, M. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 2015;372(11):10191030.CrossRefGoogle ScholarPubMed
Image Gently. Image Gently® and CT scans. Web.Google Scholar
Joint Commission. Sentinel Event Alert 38: Preventing accidents and injuries in the MRI suite. 2008.CrossRefGoogle Scholar
Kanal, E, Barkovich, J, Bell, C, et al. ACR guidance document on MR safe practices: 2013. An MRI accreditation safety review tool. J Magn Reson 2013; 37:501531.Google Scholar
Menon, BK, d’Esterre, D, Qazi, EM, et al. Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology 2015;275(2):510520.CrossRefGoogle ScholarPubMed
Miller, NR. Diagnosis and management of dural carotid-cavernous sinus fistulas. Neurosurg Focus 2007;23(5):E13.Google ScholarPubMed
National Academies. Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII, Phase 2. National Academies, 2006.Google Scholar
National Council on Radiation Protection and Measurements. Ionizing Radiation Exposure of the Population of the United States: Recommendations of the National Council on Radiation Protection and Measurements, March 3, 2009. National Council on Radiation Protection and Measurements, 2009.Google Scholar
National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333(24):15811587.CrossRefGoogle Scholar
Nishijima, DK, Offerman, SR, Ballard, DW, et al. Immediate and delayed traumatic intracranial hemorrhage in patients with head trauma and preinjury warfarin or clopidogrel use. Ann Emerg Med 2012;59(6):460468.Google Scholar
Nogueira, RG, Jadhav, AP, Haussen, DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2018;378(1):1121.CrossRefGoogle ScholarPubMed
Powers, WJ, Rabinstein, AA, Ackerson, T, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018;49(3):e46e110.Google Scholar
Sullivan, TP, Jarvik, JG, Cohen, WA. Follow-up of conservatively managed epidural hematomas: implications for timing of repeat CT. AJNR Am J Neuroradiol 1999;20(1):107113.Google Scholar
US Food and Drug Administration. MRI (Magnetic resonance imaging). 2015.Google Scholar
Wong, HJ, Sistrom, CL, Benzer, TI, et al. Use of imaging in the emergency department: physicians have limited effect on variation. Radiology 2013;268(3):779789.Google Scholar

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