Best Evidence Topic report: Is a CT head required for patients who present to the emergency department with a first seizure?
Callum WilliamsGregory YatesPublished in: Emergency medicine journal : EMJ (2024)
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.
Keyphrases
- emergency department
- computed tomography
- dual energy
- image quality
- systematic review
- contrast enhanced
- case report
- end stage renal disease
- optic nerve
- positron emission tomography
- healthcare
- ejection fraction
- magnetic resonance imaging
- chronic kidney disease
- temporal lobe epilepsy
- palliative care
- public health
- meta analyses
- magnetic resonance
- peritoneal dialysis
- prognostic factors
- quality improvement
- randomized controlled trial
- pain management
- clinical practice
- health information
- patient reported outcomes
- patient reported
- emergency medical
- optical coherence tomography