| Lumbar puncture first: an alternative model for the investigation of lone acute sudden headache. | |
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MedLine Citation:
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PMID: 10051905 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Subarachnoid hemorrhage (SAH) is a diagnosis often considered in patients presenting to the ED with acute sudden headaches, but with normal physical examinations. Standard of care today is for these patients to be investigated by noncontrast CT scan followed by lumbar puncture (LP) for negative CTs. However, given that most investigated patients have benign headaches, most of the CT and LP results are normal. The authors studied, by means of a theoretical analysis, the impact of an alternative diagnostic model, in which LP would be the first (and, in most cases, only) diagnostic test for patients suspected of SAH who met lone acute sudden headache (LASH) criteria. Given reasonable assumptions, for every 100 patients investigated, the "LP-first" model would result in 79 to 83 fewer CT scans and only seven to 11 additional LPs, as compared with traditional strategies. Among ED headache patients meeting LASH criteria, the authors believe use of this model could result in more efficient use of resources, minimal additional morbidity, and equal diagnostic accuracy for SAH. |
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Authors:
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M J Schull |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Volume: 6 ISSN: 1069-6563 ISO Abbreviation: Acad Emerg Med Publication Date: 1999 Feb |
Date Detail:
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Created Date: 1999-04-22 Completed Date: 1999-04-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9418450 Medline TA: Acad Emerg Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 131-6 Citation Subset: IM |
Affiliation:
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Emergency Department, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. mjs@ices.on.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms* Emergencies Headache / diagnosis, etiology* Humans Models, Statistical Predictive Value of Tests Spinal Puncture* Subarachnoid Hemorrhage / diagnosis* Tomography, X-Ray Computed* |
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