CT Scans Reveal Few Strokes

Emergency room CT scans for stroke or intracranial bleeding may not be warranted

(RxWiki News) When a patient shows up in a hospital emergency room complaining of dizziness, a doctor's first line of defense is often to order a CT scan to check for serious conditions such as a stroke or bleeding in the brain.

Though the scan is fairly routine, a recent study has found that less than 1 percent indicate a serious condition, raising concern that stricter hospital guidelines for when to order CT scans for patients experiencing dizziness may be in order.

"Always ask your doctor about why a test is needed."

Dr. Syed F. Ahsan, a neuro-otologist in the department of otolaryngology-head and neck surgery at Henry Ford Hospital and study author, said his experience has been that it's extremely rare that brain or head imaging reveals significant results.

He also pointed out that previous studies have found that CT scans are not very effective in identifying serious medical conditions such as strokes and intracranial bleeding. Emergency room doctors have long known the chance of pinpointing a serious problem through such a scan is remote, but it is usually performed to catch conditions that could otherwise be overlooked.

Though dizziness could indicate a serious condition, it is more commonly caused by dehydration, anemia, blood pressure drops with standing or inner ear problems.

He hopes the study into his own institution will show the organization how to run a leaner practice by saving patients unlikely to have such a serious condition from a potentially expensive and unnecessary test. Such a move could help hospitals cut costs without sacrificing patient care.

During the study researchers conducted a retrospective review of 1,681 patients who came into a Detroit hospital emergency room with dizziness or vertigo between January 2008 and January 2011. Nearly half of those patients received a CT scan of the brain and head.

Investigators found that of those patients who received scans, only 0.74 percent indicated significant results that required intervention. Patients who were older or low income were more likely to receive a CT scan after complaining of dizziness, researchers found.

The total cost of the CT scans during the 3-year study period was nearly $1 million, which researchers said indicates stronger guidelines suggesting when CT scans are medically necessary could significantly reduce expenses in the emergency room.

The research was presented Jan. 26 at the annual Triological Society's Combined Sections Meeting in Miami Beach.

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Review Date: 
January 26, 2012