The utility of brain CT scan modality in the management of dizziness at the emergency department: A retrospective single-center study. (April 2021)

• Record Type: Journal Article
• Authors: Alawneh, Khaled Z.; Raffee, Liqaa A.; Oqlat, Ahmad A.; Oglat, Ammar A.; Al Qawasmeh, Majdi; Ali, Musaab K.; Okour, Anas M.; Al-Mistarehi, Abdel-Hameed
• Is Part Of: Annals of medicine and surgery. Volume 64(2021)
• Publication Date: 2021-04
• Subjects: Dizziness -- Vertigo -- CT scan -- MRI -- Effectiveness -- Emergency; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102220
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Objectives: This study examines the usefulness of computed tomography (CT) scans in evaluating patients with dizziness in the emergency department (ED). Methods: Medical records of patients presented with complaints of dizziness or vertigo to the ED of a tertiary university hospital and underwent head CT scans from July 2015 to June 2018 were reviewed. The patients' demographic information, presenting symptoms, and final head CT scan and Magnetic resonance imaging (MRI) results were collected. Stepwise logistic regressions were used to analyze data. Results: A total of 326 dizzy patients were included in this study. The majority of the patients (83.1%) were older than 44 years. Acute vertigo pattern of dizziness was detected among 50.6% of the patients and was more common among females than males ( p < 0.001). Of these 326 patients who underwent head CT scans, 49 (15%) had abnormal findings with acute ischemic stroke was the most common one. A total of 191 patients underwent follow-up studies. MRI accounted for 70% of the follow-up studies. Of the 134 patients who received MRI of the brain, 36 (27%) had abnormal findings. A significant correlation of RBCs level, presence of other symptoms, and frequency of episodes with the presence of vertigo ( p < 0.001) was found. Conclusion: The study's findings indicate low effectiveness of head CT scan compared to MRI for dizziness management. Future studies are suggested to provide more insights into the cost-effectiveness and utility of head CT scans and MRI in providing valuable findings. Highlights: The majority of the dizzy patients presented to the emergency were older than 44 years. Acute vertigo was detected among 50.62% of the patients and more common among elderly females. Lower effectiveness of CT scan compared to MRI in the diagnosing and management of dizziness. Significant correlation of RBCs level, presence of other symptoms, and frequency of episodes with the presence of vertigo.