Recognizing What to Order - Neurologic Imaging Flashcards
Head trauma, with clinical findings; may include skull fracture?
CT head WITHOUT contrast - MRI for problem solving.
Head trauma, penetrating?
CT head WITHOUT contrast.
Head trauma, distant, with neurologic findings?
MRI of head WITHOUT contrast.
Chronic headache?
CT or MRI head WITH and WITHOUT contrast - Yield is relatively low.
Headache, acute, severe (worst headache of life)?
CT head WITHOUT contrast - Then either CTA head or MRA head WITH or WITHOUT contrast.
–> Use of CT or MRI to subject to local preference and availability.
New headache + HIV?
MRI head WITHOUT contrast.
New headache + Pregnant?
MRI head WITHOUT contrast.
New headache, suspect meningitis?
MRI head WITHOUT contrast or CT WITHOUT contrast.
–> Use of CT or MRI subject to local preference + availability.
CVA, new deficit,
CT head WITHOUT contrast - Non contrast head CT to exclude acute intracranial hemorrhage is needed prior to thrombolytic therapy.
CVA, new deficit, >3h?
MRI head WITH or WITHOUT contrast, or MRA head and neck WITH or WITHOUT contrast, or CT head WITH or WITHOUT contrast, or CTA head WITH or WITHOUT contrast.
–> Use of CT and MRI subject to local preference and availability.
SAH proven by imaging or LP?
Cerebral arteriography or CTA of head.
CVA, suspected cerebral hemorrhage?
CT head WITHOUT contrast.
Seizure, alcohol or drug related?
MRI head WITHOUT and WITH contrast - CT can be substituted if MRI not available in emergency.
Sezure, new onset, 18-40?
MRI head WITHOUT and WITH contrast - CT can be substituted if MRI not available in emergency.
Seizure, new onset, >40?
MRI head WITH and WITHOUT contrast - CT can be substituted if MRI not available in emergency.