Abstract
Acute dizziness (including vertigo) is a common reason to visit the emergency room, and imaging with head CT is often performed initially to exclude a central cause. In this study, consecutive patients presenting with dizziness and undergoing head CT were retrospectively reviewed to determine diagnostic yield. Four hundred forty-eight consecutive head CTs in a representative sample of dizzy emergency room (ER) patients, including patients with other neurological symptoms, were reviewed to identify an acute or subacute cause for acute dizziness along with the frequency and modalities used in follow-up imaging. The diagnostic yield for head CT ordered in the ER for acute dizziness is low (2.2 %; 1.6 % for emergent findings), but MRI changes the diagnosis up to 16 % of the time, acutely in 8 % of cases. Consistent with the American College of Radiology appropriateness criteria and the literature, this study suggests a low diagnostic yield for CT in the evaluation of acute dizziness but an important role for MRI in appropriately selected cases.
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Notes
Intracranial stenosis revealed on follow-up imaging was classified as a new acute finding if it was associated with TIA-like symptoms; otherwise, it was considered sub-acute.
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Acknowledgments
The authors would like to thank Jack Collins, Sarah Orrin, Jay Patel, Danny Cheng, and Will Whetsell for their assistance with data collection. Our work was supported by the Arthur Quern fellowship and the University of Chicago Pritzker School of Medicine Summer Research Program.
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Summary statement
Head CT was found to have a low diagnostic yield for patients presenting to the emergency room with dizziness.
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Lawhn-Heath, C., Buckle, C., Christoforidis, G. et al. Utility of head CT in the evaluation of vertigo/dizziness in the emergency department. Emerg Radiol 20, 45–49 (2013). https://doi.org/10.1007/s10140-012-1071-y
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DOI: https://doi.org/10.1007/s10140-012-1071-y