J Neurosci Rural Pract. 2019 Apr-Jun;10(2):207-211. doi: 10.4103/jnrp.jnrp_362_18.
Pattern of Emergent Head Computed Tomography Findings in a Tertiary Care Hospital during off Working Hours: Retrospective Analysis.
Journal of neurosciences in rural practice
Rajneesh K Patel, Amit Kumar Choubey, Brijesh K Soni, Rajeev Sivasankar, Vikash Chauhan
Affiliations
Affiliations
- Department of Radiodiagnosis, Indian Naval Hospital Ship Asvini, Mumbai, Maharashtra, India.
- Department of Radiodiagnosis, Indian Naval Hospital Ship Sanjivani, Kochi, Kerala, India.
PMID: 31001006
PMCID: PMC6454959 DOI: 10.4103/jnrp.jnrp_362_18
Abstract
INTRODUCTION: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient's expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings.
MATERIALS AND METHODS: A retrospective analysis of all emergent noncontrast CT head during off working hours in the Department of Radiodiagnosis of a Tertiary Care Hospital, Mumbai, India, which were performed from June 2017 to May 2018. CT findings of 308 patients were analyzed.
RESULTS: About 63.6% of total head CT showed no significant abnormality. The most common abnormality was intracranial hemorrhage which was just 9.1% followed by acute infarct which was 6.2%. Extradural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage was only 1% each of total head CT findings. No significant abnormality was detected in 74.65%, 70.21%, 89.13%, 31.37%, 100%, and 69.09% in cases of head injury, seizure, giddiness/dizziness/syncope, cerebrovascular accident, transient ischemic attack, and altered sensorium, respectively.
CONCLUSION: Pattern analysis of emergent head CT reveals that most of the emergent CT head shows no significant abnormality. There is a need for stringent guidelines for emergent head CT, training of emergency physician as well as CT technician for common findings to bridge the radiologist demand-supply gap for providing effective health care in peripheral hospitals.
Keywords: Emergency computed tomography; head computed tomography; head injury; noncontrast computed tomography head; seizure; syncope
Conflict of interest statement
There are no conflicts of interest.
References
- N Engl J Med. 2000 Jan 6;342(1):42-9 - PubMed
- Ann Emerg Med. 2001 Aug;38(2):160-9 - PubMed
- J Neurol Neurosurg Psychiatry. 2002 May;72(5):587-9 - PubMed
- AJR Am J Roentgenol. 2003 Jun;180(6):1727-30 - PubMed
- CMAJ. 1992 Dec 1;147(11):1671-8 - PubMed
- Emerg Med J. 2005 Apr;22(4):312 - PubMed
- Radiology. 2005 Jun;235(3):756-73 - PubMed
- Emerg Radiol. 2005 Dec;12(1-2):44-6 - PubMed
- J Am Geriatr Soc. 2006 Apr;54(4):587-92 - PubMed
- Intern Emerg Med. 2007 Mar;2(1):46-9 - PubMed
- N Engl J Med. 2007 Nov 29;357(22):2277-84 - PubMed
- J Trauma. 2008 Jul;65(1):66-72 - PubMed
- Emerg Med Australas. 2008 Oct;20(5):420-4 - PubMed
- Arch Intern Med. 2009 Dec 14;169(22):2078-86 - PubMed
- Radiology. 2011 Jan;258(1):164-73 - PubMed
- Medicine (Baltimore). 1990 May;69(3):160-75 - PubMed
- J Am Acad Orthop Surg. 2013 Oct;21(10):624-31 - PubMed
- Quant Imaging Med Surg. 2014 Dec;4(6):449-50 - PubMed
- AJR Am J Roentgenol. 2015 Jan;204(1):24-8 - PubMed
- Seizure. 2017 May;48:89-93 - PubMed
- Epilepsia. 2018 Sep;59(9):1676-1683 - PubMed
- Emerg Med Clin North Am. 1985 Aug;3(3):437-46 - PubMed
- Arch Intern Med. 1985 Jul;145(7):1257-9 - PubMed
- Age Ageing. 1993 Jul;22(4):240-3 - PubMed
- Acad Emerg Med. 1997 Dec;4(12):1107-10 - PubMed
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