&lt;p&gt;Brain CT Findings in Patients with First-Onset Seizure Visiting the Emergency Department in Mashhad, Iran&lt;/p&gt;

Zarmehri, Bahram; Teimouri, Ali; Ebrahimipour, Navid; Foroughian, Mahdi; Talebzadeh, Vahid; Saeidi, Morteza; Alirezaei, Mehran

doi:10.2147/oaem.s241124

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…In another study by Zarmehri et al, their study population had a mean age of 39.78 ± 17 years. 11 Additionally, this study revealed that elderly patients had more abnormal CTB findings. More vascular pathologies were seen in older patients and more infective pathologies in younger and HIV infected patients.…”

Section: Discussionmentioning

confidence: 63%

“…A study by Zarmehri et al also consisted of more males, accounting for 62% of their study population. 11 In contrast, in a retrospective study performed in South Africa by Smith et al, their study sample consisted of more females, accounting for 61.2%. 7 Another study by Kaur et al had 65% male subjects.…”

Section: Discussionmentioning

confidence: 84%

“…This is slightly different from the international literature, where neoplastic pathology contributed 8% – 14.8% of abnormal CTB findings. 11 , 12 Focal seizures were seen in 50% of cases with neoplastic pathology but there was poor documentation of seizure type and statistical significance was not reached.…”

Section: Discussionmentioning

confidence: 99%

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An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa

Mabaso

Bhana-Nathoo

Lucas

2022

South African Journal of Radiology

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Background Globally, adults presenting with seizures account for 1% – 2% of visits to emergency departments (EDs), of which 25% are new-onset seizures. Neuroimaging is essential as part of the initial workup. Multiple studies have demonstrated abnormal CT brain (CTB) findings in these patients. Objectives To review the CTB findings in adults presenting with new-onset seizures in a resource restricted setting. Method A retrospective review of 531 CTBs was conducted at a tertiary hospital in Gauteng on adults presenting to the ED with new-onset seizures. Results The mean age of the patients was 45.6 ± 17.1 years, and the male to female ratio was 1.2:1. Generalised and focal seizure types were almost equally represented. Of the total 531 patients, 168 (31.6%) were HIV positive. The CTB findings were abnormal in 257 (48.4%) patients, albeit vascular pathology accounted for 21.9%. Infective pathology accounted for 14.1% with a statistically significant association with HIV ( p = 0.003). Trauma related pathology was 2.4%, whilst neoplastic pathology was seen in 3.0%. Other causes included congenital pathology, calcifications, atrophy and gliosis. Clinical factors associated with abnormal CTB findings were age ≥ 40 years, HIV infection, hypertension, focal seizures, low Glasgow Coma Scale (GCS), raised cerebrospinal fluid (CSF) protein and presence of lymphocytes. Conclusion A high yield of abnormal CTB findings was noted in adult patients who presented with new-onset seizures, supporting the use of urgent CTB in patients with certain clinical risk factors. Patients without these risk factors can be scanned within 24–48 h in a resource restricted setting.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 84%

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An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa

Mabaso

Bhana-Nathoo

Lucas

2022

South African Journal of Radiology

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Justification of Urgent Brain CT scans at Palestinian Government Hospitals

Nazzal,

Ahmad,

Mohammad

2024

J. Phys.: Conf. Ser.

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CT In cases of mild brain injury emergencies, CT scans can be valuable. However, misuse can result in radiation exposure and increased costs. This study examines CT scan utilization in Palestinian government hospitals, using a comprehensive multi-hospital analytical approach. It involved 66 emergency doctors and residents from Darwish Nazzal, Al Hussein, and Palestine Medical Complex. Findings indicate disparities in CT scan ordering practices among emergency physicians. Only 33.3% adhere to recommended guidelines, while 10.6% request scans for non-medical reasons. A lack of awareness regarding radiation exposure is seen in 39.4% of clinicians. Moreover, there are variations in image interpretation and ordering practices between morning and night shifts. Cost concerns are expressed by 68.2% of doctors, and 14.5% of CT scans were unjustified, often due to vague requests. This study underscores the importance of educating clinicians on radiation risks and promoting adherence to current CT scan criteria. Local guidelines and checklists are needed to justify CT scans, and physicians should participate in seminars on radiation doses and maximum allowable levels to reduce unnecessary scans. The hiring of night-shift radiologists in public hospitals is also recommended to enhance patient records and reduce costs.

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Best Evidence Topic report: Is a CT head required for patients who present to the emergency department with a first seizure?

Williams,

Yates

2024

Emerg Med J

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A short systematic review was undertaken to assess whether adult patients presenting to the ED with a first seizure require a CT head scan to rule out emergent intracranial pathology. MEDLINE, EMBASE, Cochrane and Google Scholar databases were searched. Seven relevant papers were identified. Study information, patient characteristics, key results and methodological weaknesses were tabulated. Our results indicate that adults presenting with a first seizure are a high-yield group for CT with a number needed to scan (NNS) between 10 and 19 for findings that would change management in ED, such as haemorrhage, infarction and tumours. We believe that this NNS is sufficiently low to justify the routine use of neuroimaging for these patients in emergency care.

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<p>Brain CT Findings in Patients with First-Onset Seizure Visiting the Emergency Department in Mashhad, Iran</p>

Cited by 3 publications

References 19 publications

An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa

An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa

Justification of Urgent Brain CT scans at Palestinian Government Hospitals

Best Evidence Topic report: Is a CT head required for patients who present to the emergency department with a first seizure?

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