• Eur J Emerg Med · Feb 2013

    Urgent computed tomography brain scan for elderly patients: can we improve its diagnostic yield?

    • Philippe Le Conte, Emmanuel Montassier, Julien Segard, David Trewick, and Gilles Berrut.
    • Emergency Department, University Hospital Hotel Dieu of Nantes, Nantes, France. segard.julien@gmail.com
    • Eur J Emerg Med. 2013 Feb 1;20(1):51-3.

    AbstractWe 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.

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