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Urgent computed tomography brain scan for elderly patients: can we improve its diagnostic yield?
MedLine Citation:
PMID:  22186148     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We conducted a retrospective study of 291 patients aged 75 years or older who were admitted to the emergency department and who underwent a computed tomography (CT) brain scan. Our aims were to assess the reasons for requesting an urgent CT brain scan, to record the diagnostic yield of cerebral imaging, and to seek out predictive factors of an intracranial pathology. The three main reasons for requesting an urgent CT brain scan were the presence of localizing signs (60%), delirium (21%), and disorders of consciousness with a Glasgow Coma Score of less than 14 (14.5%). In our elderly population, we found no typical patient profile when concerned with the risk of having an intracranial pathology. The multivariate logistic regression found that predictive factors for intracranial bleeding were localizing signs, disorders of consciousness with a Glasgow Coma Score of less than 14, head trauma, sudden-onset headache, or headache associated with at least two episodes of vomiting.
Authors:
Julien Segard; Emmanuel Montassier; David Trewick; Philippe Le Conte; Benoit Guillon; Gilles Berrut
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-18
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  -     ISSN:  1473-5695     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aEmergency Department, University Hospital Hotel Dieu of Nantes bDepartments of Neurology cGeriatrics, University Hospital Laennec of Nantes, Nantes, France.
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