Evaluation of common findings in brain computerized tomography (CT) scan: A single center study (original) (raw)
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Pakistan Journal of Health Sciences
Cranial computed tomography (CT) is the most generally utilized diagnostic method for the emergent evaluation of head trauma (TBIs) because it is readily accessible, quick, and sensitive for clinically relevant traumatic brain injuries as well as non-traumatic abnormalities. Objective: To determine the frequency, causes, and findings of brain computed tomography scan at The University of Lahore teaching hospital. Methods: A descriptive study was conducted at The University of Lahore Teaching Hospital. A sample of 202 brain CT scans from a total of 933 participants seen in the CT department was obtained using a suitable sampling technique. Data analysis was done using SPSS version 21.0. Results: There were 78 (38.6%) female patients and 124 (61.4%) male patients out of 202 total patients. The mean age of the patients was 47.1± 23 years. The most prevalent of them, brain atrophy, was observed in 63 (31.2%) of the patients. 51 (25.2%) patients had infarction, 36 (17.8%) had sinusitis,...
Heliyon, 2021
Introduction: Headache is a common and sometimes debilitating medical condition. Patients presenting with no neurologic anomaly, nontraumatic primary headache require careful evaluation before neuroimaging. National Guidelines standardizing exploitation of Computed Tomography (CT), the most utilized imaging modality in this clinical scenario, has not been established in Ghana, a developing country with limited healthcare resources. The country has not also adopted existing guidelines such as the National Institute for Health and Care Excellence (NICE) of the United Kingdom or the Appropriateness Criteria (AC) of the American College of Radiologists (ACR). The purpose of this review was to analyze the propensity of CT utilization for diagnosing headaches against the AC of the ACR and discuss some of the socioeconomic inferences thereof. Methods: This study retrospectively reviewed CT imaging records and clinical data of all patients referred for head CT scans between 1 st January 2016 and 31 st December 2018 at five major health facilities (four tertiary government hospitals and one private hospital) across Ghana. We isolated all head CT scans performed for the diagnosis of headache for analysis. We analyzed the type of presenting headache, CT findings, gender distribution, pattern of referrals, and head CT appropriateness against the AC of the ACR. Results: A total of 44,218 patients were referred to the five facilities for head CT secondary to diverse indications for the period. All non-trauma cases were 41.7%; trauma cases were 31.6%, the majority (72.3%) were from road traffic accidents. The majority (64.9%) of trauma casualties were males. A total of 11,806 (26.7%) patients were referred for a head CT scan for the diagnosis of headache. The private hospital recorded the highest referrals for head CT scan for diagnosis of headache. The gender distribution of all headache patients was 57.6% females, and 42.4% were males. The age distribution showed 19.3% were children, 71.2% were adults, and the aged constituted 9.4%. The results showed 2.8% significant cranial CT findings of all reviewed headache patients. Pathological findings among the cohort of children were 0.6%. The sources and pattern of referrals showed 57.3% were from the Outpatient Department, 26.6% from the Emergency Department, in-patients' referrals were 9.4%, and specialist consultation was 7.1%. Analysis of CT scans performed against the AC of the ACR, showed 69.0% of headache patients were likely scanned inappropriately. Conclusions: There is a need to implement international best practice guidelines or develop a national neuroimaging policy to protect patients. Unjustified CT utilization for diagnosis of headaches exposes patients to unnecessary ionizing radiation that can instigate cancer and unnecessary expenditure. Head CT scan for some headache patients with normal neurologic findings may be unnecessary in an emerging country like Ghana. Clinicians must, therefore, be discerning in CT scan requests for the diagnosis of headache.
CT Findings in Adult Headache in Sub-Saharan Africa
Asian Journal of Medical Radiological Research, 2019
Background: To determine CT findings in adult headache in sub-Saharan Africa. Subjects and Methods: a prospective study of six months duration carried out at the military hospital of Abidjan. It included all patients who underwent a brain CT for headache. The CT scans were performed in spontaneous contrast, supplemented according to the context by another complementary acquisition after injection of iodinated contrast medium. The epidemiological and clinical data were obtained from the patients' examination interview. Results: The total number of our patients was 129. There was a predominance with 52% (n = 67) of women against 48% men (n = 62). The average age was 44 years. The associated clinical symptoms were: motor deficit (30.2%) and fever (11%). In 58.8% of cases there were no associated signs. In 17 cases there was a notion of combined hormonal taking, 20 cases of hypertension and 10 cases of trauma. CT revealed in 46.2% of cases a cause for headache. These etiologies were dominated by stroke (24%), followed by sinusitis (9.3%), abscesses and encephalitis (7.8%) and trauma (5.4%). Conclusion: In sub-Saharan Africa headache is frequently explored in neuroradiology. This is a serious symptom for which CT revealed in 46.2% of cases an underlying cause dominated by decreasing order of frequency: stroke, sinusitis and brain abscess.
An analysis of 2800 CT Head scans in patients with chronic headache
International Journal of Medical Research and Review
Introduction: Chronic headache is a common health problem in general medical practice and there is increasing demand of CT scan from specialist as well as non-specialist doctors to refer patients for CT head scan. Patients and methods: The present study was done on 2800 CT head scans of patients with problem of chronic headache. While patients in Group 1 (n=1900) had only chronic headache without any neurological findings, Group B comprised of cases (n=900) referred by specialist doctors after neurological examination. CT scan was done by trained technicians and contrast was injected where necessary. Results: Present study showed majority of patients in both group 1 and group 2 (90% and 87.7% respectively) had normal CT findings or insignificant findings. However, difference was not significant in both groups when significant findings (10.0% Gr. A and 12.2% Group B) were compared. Discussion: Our findings are consistent with other studies concluding that routine CT scan may not provide clinically useful information in chronic headache.
Red flags in patients presenting with headache: clinical indications for neuroimaging
The British Journal of Radiology, 2003
Headache is a very common patient complaint but secondary causes for headache are unusual. Neuroimaging is both expensive and has a low yield in this group. Most patients with intracranial pathology have clinical features that would raise a ''red flag''. Appropriate selection of patients with headache for neuroimaging to look for secondary causes is very important. Red flags act as screening tools to help in identifying those patients presenting with headache who would benefit from prompt neuroimaging, and may increase the yield. The aim of this study is to evaluate clinical features in patients with headache using neuroimaging as a screening tool for intracranial pathology. 20 red flags were defined. A retrospective study of 111 patients was performed and the outcomes were divided into positive and negative. Abnormal neuroimaging was present in 39 patients. Results were analysed using the Logistic Regression model. Sensitivity and specificity of red flags were analysed to establish the cutoff point to predict abnormal neuroimaging and a receiver operating characteristic (ROC) curve plotted to show the sensitivity of the diagnostic test. Three red flag features proved to be statistically significant with the p-value of less than 0.05 on both univariate and multivariate analysis. These were: paralysis; papilloedema; and ''drowsiness, confusion, memory impairment and loss of consciousness''. In addition, if three or more red flags from the list were present, this showed strong indication of abnormal neuroimaging, from cutoff point of ROC curve (area under the curve 50.76).
Journal of Patan Academy of Health Sciences, 2021
Introduction: Non-traumatic headaches are a common presentation in emergency services. A non-contrast computed tomography (NCCT) scan of the head is done when there is suspicion of intracranial abnormalities. Such intracranial abnormalities are indicated by "red flag" signs. This study aimed to determine the prevalence of intracranial abnormalities in patients with non-traumatic headaches and its association with the red flag signs. Method: A total of 106 patients presenting with a non-traumatic headache to the emergency services of TUTH from Aug 2019 to Aug 2020, who underwent head CT were included in the study. The association of head CT positivity with the presence of red flag signs was studied by bivariate analysis using the chi-square test or Fisher exact test. Result: Among 106 patients, 46(43.4%) were male and the rest were female. The mean age of the patient was 43.69+17.46. All the patients who had positive findings in head CT had at least one red flag sign. Out o...
Evaluation of Diagnostic Value of Computed Tomography in Headache Patients in Benghazi
Al-Mukhtar Journal of Sciences
Headache is the most common complaint faced by physicians. Referring these cases for a computed tomography (CT) scan requires awareness of red flags in the history and examination by physicians. An assessment of the diagnostic utility of CT among headache patients will help determine the most prevalent causes of headache and identify those who get benefit from it. is to find out the proportion of cranial abnormalities in patients with headache without neurologic abnormalities with the use of a CT scan. Also, to illustrate the most common causes of headache in these patients. This study was carried out among 217 patients with isolated headache who underwent a plain, non-contrast enhanced CT of the brain and para-nasal sinus (PNS).The median age was 34 years. The most prevalent age group was between 20 and 39 years old. The most common cases were females. The female to male ratio was 1.5:1. The most frequently occurring cases in 2012 came from the ear, nose, and throat (ENT) departmen...
Journal of family medicine and primary care
Headache disorders are one of the most prevalent global public-health problems that require placing high demand on health-care Services. Since it is one of the most frequent complaints in clinical practice worldwide, it causes a considerable burden in terms of the social cost. The study aimed to give a guide for the decision on the utilization of computed tomography (CT) in the diagnostic workup and identify if patients require neurological imaging (CT) for proper diagnosis or not. The study was carried out in the Radiology Department in King Khalid Hospital, Al Kharj, Saudi Arabia from October 15, 2016, to February 15, 2017. A retrospective record-based study conducted using the documented CT reports in the files of patients whom were referred to the radiology department complaining of any type of a headache. The data included 210 patients 51% were males and 49% were females. The patients were distributed into age groups; the mean age was 38.46 standard deviation ± 13.56. Among Sau...
Background: Headache is a common complaint in clinical practice, though most patients who present with headache have no neurological abnormality on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) investigations. Good knowledge of the patterns of MR image findings in patients with a headache would serve as a guide to neurosurgeons and clinicians in the management of these patients. This study was designed to evaluate the MR image findings in patients with headache in our locality.