Emergency radiology
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The last decade witnessed significant and unprecedented advances in the treatment of acute ischemic stroke. Intravenous tissue plasminogen activator and defibrinogenating agent are both now approved by the Food and Drug Administration for treatment of acute ischemic stroke within 3 h of symptom onset. ⋯ The future for the development of new and better treatment for ischemic stroke looks very promising. Currently, induced hypothermia, laser evaporation, mechanical thrombectomy, angioplasty with stent placement, the combination of neuroprotective agents with thrombolysis, and the combination of intravenous with intra-arterial thrombolysis are being investigated.
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Emergency radiology · Dec 2004
Case ReportsAutosomal dominant polycystic kidney disease presenting as subarachnoid hemorrhage.
Intracranial aneurysms occur in patients with autosomal dominant polycystic kidney disease (ADPKD) approximately five times more often than in the general population, and in the same patient group, subarachnoid hemorrhage from rupture of aneurysms occurs about a decade earlier than in the general population. We present a case of unsuspected ADPKD presenting as spontaneous subarachnoid hemorrhage from a ruptured intracranial aneurysm.
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Emergency radiology · Aug 2004
Review Case ReportsIntrathecal injection of epidural blood patch: a case report and review of the literature.
Epidural blood patch (EBP) is a commonly performed procedure for the treatment of persistent severe post- dural-puncture headache (PDPH). It has a high success rate with a low incidence of complications. We report the case of a 27-year-old woman who developed progressive back pain and radicular symptoms after an EBP was performed for PDPH. ⋯ Gradual recovery occurred without the need for intervention. To our knowledge, this is the only case demonstrating the MRI findings of a rare complication of a common procedure. Radiologists may benefit from familiarity with epidural blood patching, including the technique, risks, benefits, and potential complications
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Emergency radiology · Jul 2004
ReviewControversies in emergency radiology. CT versus ultrasound in the evaluation of blunt abdominal trauma.
There has been controversy regarding ultrasonography (US) versus CT in blunt abdominal trauma (BAT). Each modality has its strengths and weaknesses. US is fast and allows resuscitative efforts to proceed while the patient is being scanned. ⋯ However, CT involves ionizing radiation, cannot be performed portably, and requires only visual monitoring while scanning. Given each modality's strengths and weaknesses we conclude that CT is the preferred examination when the BAT patient is stable or moderately stable, enough to be taken to CT. If a BAT patient is unstable, US is beneficial in screening for certain injuries or large hemoperitoneum prior to an exploratory laparotomy.
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Emergency radiology · Jul 2004
Patient encounter time intervals in the evaluation of emergency department patients requiring abdominopelvic CT: oral contrast versus no contrast.
The aim of the study was to assess various time intervals during patient encounters involving unenhanced (NECT) versus oral-contrast-enhanced (CECT) abdominopelvic (A/P) CT performed in the emergency department (ED) on adult patients presenting with acute abdominal pain. Computerized patient order entry and administrative data as well as scans themselves were retrospectively evaluated at a high-volume (107,000 visits per annum) regional medical center urban ED for a period of 30 consecutive days. All adult patients who had CT of abdomen and pelvis for abdominal pain during the 30 days of the study period were included. ⋯ There are significant time interval differences between CECT and NECT during patient encounters involving adults presenting with abdominal pain to the ED. The differences are greater than the amount of time allotted for opacification of small bowel (90 min). Baseline data such as these may prove useful in assessing the efficacy of scan techniques and improving resource utilization.