Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep 24;6(9):1664-1667.
doi: 10.3889/oamjms.2018.340. eCollection 2018 Sep 25.

Value of Head CT Scan in the Emergency Department in Patients with Vertigo without Focal Neurological Abnormalities

Tomislav Pavlović  1   2 , Marina Milošević  3 , Sanja Trtica  1 , Hrvoje Budinčević  2   3
Affiliations

Value of Head CT Scan in the Emergency Department in Patients with Vertigo without Focal Neurological Abnormalities

Tomislav Pavlović et al. Open Access Maced J Med Sci. .

Abstract

Background: Vertigo is a common symptom and reason for admission to the emergency department (ED).

Aim: This research aimed to determine the incidence of clinically significant findings on computed tomography (CT) in patients with vertigo without focal neurological abnormalities in the ED.

Material and methods: The results of the native CT scans in the ED were retrospectively analysed. Exclusion criteria included: focal neurological abnormalities, underlying malignancy, brain metastasis, previous brain operation, headache, fever, nausea, vomiting, head trauma, coagulopathy. As a clinically significant finding, we took into an account tumour, haemorrhage and acute ischemic lesion. 72 patients fulfilled the set criteria, present vertigo, without focal neurological abnormalities. Out of 72 patients with a median age of 62 (23-87) years old, 54% of the patients were female, and 46% were male.

Results: Normal CT findings were found in 44 patients (61.1%), 28 patients (38.9%) had pathological findings, out of that number 23 (31.9%) findings were clinically irrelevant and 5 (6.9%) were clinically significant. Out of the 5 clinically significant findings, tumour process was found in 3 (4.2%) patients, haemorrhage was found in 1 (1.4%) patient, and the ischemic lesion was found in 1 (1.4%) patient. Additional evaluation of five clinically significant findings showed a change of initial diagnosis in one case, but the significance of the finding remained the same.

Conclusion: Our study demonstrates a low diagnostic yield of head CT examination with 6.9% of clinically significant findings in patients with vertigo without focal neurological abnormalities.

Keywords: Computed tomography (CT); Emergency department; Vertigo.

PubMed Disclaimer

References

    1. Ahsan SF, Syamal MN, Yaremchuk K, Peterson E, Seidman M. The costs and utility of imaging in evaluating dizzy patients in the emergency room. Laryngoscope. 2013;123(9):2250–3. https://doi.org/10.1002/lary.23798 PMid:23821602. - PubMed
    1. Newman-Toker DE, Hsieh YH, Camargo CA, Pelletier AJ, Butchy GT, Edlow JA. Spectrum of dizziness visits to US emergency departments:cross-sectional analysis from a nationally representative sample. Mayo Clin Proc. 2008;83(7):765–75. https://doi.org/10.4065/83.7.765 PMid:18613993 PMCid:PMC3536475. - PMC - PubMed
    1. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117(11):898–904. https://doi.org/10.7326/0003-4819-117-11-898 PMid:1443950. - PubMed
    1. Hanley K, O'Dowd T, Considine N. A systematic review of vertigo in primary care. Br J Gen Pract. 2001;51(469):666–71. PMid:11510399 PMCid:PMC1314080. - PMC - PubMed
    1. Cappello M, di Blasi U, di Piazza L, Ducato G, Ferrara A, Franco S, et al. Dizziness and vertigo in a department of emergency medicine. Eur J Emerg Med. 1995;2(4):201–11. https://doi.org/10.1097/00063110-199512000-00006 PMid:9422208. - PubMed

LinkOut - more resources