Emergency radiology
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Emergency radiology · Apr 2016
Effect of spinal immobilisation devices on radiation exposure in conventional radiography and computed tomography.
Trauma patients at risk for, or suspected of, spinal injury are frequently transported to hospital using full spinal immobilisation. At the emergency department, immobilisation is often maintained until radiological work-up is completed. In this study, we examined how these devices influence radiation exposure and noise, as a proxy for objective image quality. ⋯ Removing the headblocks led to a statistically significant improvement in transmission with automatic exposure control (AEC) enabled. Physicians should make an informed decision whether the increased radiation exposure outweighs the risk of missing a clinically significant injury by not making a CR or CT scan. Manufacturers of immobilisation devices should take radiological properties of their devices into account in the development and production process.
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Nasotracheal intubation (NTI) is used for maintaining airway access during maxillofacial surgery or in cases of severe oral trauma. We describe a case of middle turbinectomy complication as a result of NTI. The purposes of this paper are to raise awareness of this complication and review associated imaging findings.
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Emergency radiology · Apr 2016
Cross-sectional imaging of thoracic and abdominal complications of cerebrospinal fluid shunt catheters.
This study aims to review the imaging findings of distal (thoracic and abdominal) complications related to ventriculo-peritoneal (VP), ventriculo-pleural (VPL), and ventriculo-atrial (VA) cerebrospinal fluid (CSF) shunt catheter placement. Institution review board-approved single-center study of patients with thoracic and abdominal CSF catheter-related complications on cross-sectional imaging examinations over a 14-year period was performed. Clinical presentation, patient demographics, prior medical history, and subsequent surgical treatment were recorded. ⋯ Ten patients (33.3 %) had features of temporally related acute or worsening hydrocephalus on neuroimaging. In four of these patients, the detection of thoracic and abdominal complications on CT preceded and predicted the findings of acute hydrocephalus on cranial imaging. Thoracic and abdominal complications of CSF shunts, as can be identified on CT, include shunt infection and/or obstruction, may be both multiple and recurrent, and may be predictive of concurrent acute intracranial problems.
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Emergency radiology · Feb 2016
Head CT scan in Iranian minor head injury patients: evaluating current decision rules.
The objective of this study is to select one of the seven available clinical decision rules for minor head injury, for managing Iranian patients. This was a prospective cohort study evaluating medium- or high-risk minor head injury patients presenting to the Emergency Department. Patients with minor head trauma who were eligible for brain imaging based on seven available clinical decision rules (National Institute for Health and Clinical Excellence (NICE), National Emergency X-Radiography Utilization Study (NEXUS)-II, Neurotraumatology Committee of the World Federation of Neurosurgical Societies (NCWFNS), New Orleans, American College of Emergency Physicians (ACEP) Guideline, Scandinavian, and Canadian computed tomography (CT) head rule) were selected. ⋯ Of seven decision rules, only the Canadian CT Head Rule possesses seven of the eight high-risk factors associated with abnormal head CT results which were identified by this study. This study underlines the Canadian CT Head Rule's utility in Iranian minor head injury patients. Our study encourages researchers to evaluate available guidelines in different communities.
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Emergency radiology · Feb 2016
Case ReportsImaging features and differentials in surfer's myelopathy: a case report.
Surfer's myelopathy is a rare non-traumatic cause of myelopathy found in novice surfers. We present a case of a 23-year-old female who developed acute and rapidly progressive bilateral lower extremity paraplegia, paresthesia, and anesthesia, accompanied by lower back discomfort and bowel and bladder dysfunction after surfing for the first time. She had a past history of auto-resolved lower extremity weakness that could be related to anatomy variation of spinal cord vascular supply. ⋯ We discuss radiological findings of acute spinal cord infarct and longitudinal extensive transverse myelitis (LETM) as possible differentials in this case. The diagnosis of surfer's myelopathy relies on a first time surfing history since the clinical and radiological presentations can be similar to other entities in some cases. Thus, we highlight the importance of a full clinical report and efficient communication between referring clinicians and radiologists for a precise and early diagnosis.