OBJECTIVE: Current guidelines for evaluation of syncope recommend that in the absence of objective focal neurologic findings, head computed tomography (HCT) may not be necessary. Compliance with this recommendation is highly variable, which may be due in part to the lack of currently available evidence. We undertook the following investigation to determine whether HCT aids in the diagnostic investigation of syncope. METHODS: This study was a retrospective chart review of all adult patients who presented to an urban emergency department, and who had a HCT ordered for syncope, during a 6-month period in 2001. Patients with competing indications for HCT, or those with a presentation consistent with seizures were excluded. Charts were assigned to the "positive" or "negative" HCT group depending on whether the treating physician considered HCT findings relevant to the syncopal event. RESULTS: A total of 202 patients had a HCT performed for syncope. Eighty-five patients met one or more of the exclusion criteria. HCT of the remaining 117 patients were analyzed. None of the 117 patients had a HCT finding that was clinically related to the syncopal event. CONCLUSIONS: HCT yielded no relevant clinical findings in our entire sample of patients with syncope. Our findings combined with previous studies add to the growing body of evidence that HCT for syncope in the absence of focal neurologic findings may not be necessary.
OBJECTIVE: Current guidelines for evaluation of syncope recommend that in the absence of objective focal neurologic findings, head computed tomography (HCT) may not be necessary. Compliance with this recommendation is highly variable, which may be due in part to the lack of currently available evidence. We undertook the following investigation to determine whether HCT aids in the diagnostic investigation of syncope. METHODS: This study was a retrospective chart review of all adult patients who presented to an urban emergency department, and who had a HCT ordered for syncope, during a 6-month period in 2001. Patients with competing indications for HCT, or those with a presentation consistent with seizures were excluded. Charts were assigned to the "positive" or "negative" HCT group depending on whether the treating physician considered HCT findings relevant to the syncopal event. RESULTS: A total of 202 patients had a HCT performed for syncope. Eighty-five patients met one or more of the exclusion criteria. HCT of the remaining 117 patients were analyzed. None of the 117 patients had a HCT finding that was clinically related to the syncopal event. CONCLUSIONS: HCT yielded no relevant clinical findings in our entire sample of patients with syncope. Our findings combined with previous studies add to the growing body of evidence that HCT for syncope in the absence of focal neurologic findings may not be necessary.
Authors: J Rydberg; K A Buckwalter; K S Caldemeyer; M D Phillips; D J Conces; A M Aisen; S A Persohn; K K Kopecky Journal: Radiographics Date: 2000 Nov-Dec Impact factor: 5.333
Authors: Michele Brignole; Paolo Alboni; David G Benditt; Lennart Bergfeldt; Jean-Jacques Blanc; Poul Erik Bloch Thomsen; J Gert van Dijk; Adam Fitzpatrick; Stefan Hohnloser; Jan Janousek; Wishwa Kapoor; Rose Anne Kenny; Piotr Kulakowski; Giulio Masotti; Angel Moya; Antonio Raviele; Richard Sutton; George Theodorakis; Andrea Ungar; Wouter Wieling; Silvia G Priori; Maria Angeles Alonso Garcia; Andrzej Budaj; Martin Cowie; Jaap Deckers; Enrique Fernandez Burgos; John Lekakis; Bertil Lindhal; Gianfranco Mazzotta; João Morais; Ali Oto; Otto Smiseth; Carlo Menozzi; Hugo Ector; Panos Vardas Journal: Eur Heart J Date: 2004-11 Impact factor: 29.983
Authors: David M Studdert; Michelle M Mello; William M Sage; Catherine M DesRoches; Jordon Peugh; Kinga Zapert; Troyen A Brennan Journal: JAMA Date: 2005-06-01 Impact factor: 56.272