title: Value of contrast enhanced CT scanning in the non-trauma emergency room patient.
abstract: To determine the value of performing contrast CT in addition to non-contrast CT in the evaluation of acute non-traumatic central nervous system disorders, we retrospectively reviewed 322 cases originating from the emergency room at our institution. The most common indication for scanning was seizure activity (34% of total), followed by headache (30%), focal neurological deficit (10%), and altered mental status (8%). 75% of the non-contrast scans were normal. The contrast-enhanced scan revealed abnormalities not evident on the non-contrast scan in only three of these cases, and the information did not alter patient management. We conclude that in the acute setting, if a non-contrast CT is normal, a contrast study is usually unnecessary. Therefore, given the additional risks of contrast infusion, the contrast study, if needed, is generally best obtained at a later date, after more careful evaluation of the patient's history and medical records. If the non-contrast CT scan is abnormal, a contrast enhanced CT scan may be beneficial, but, again, is often not needed to direct acute patient management.
authors.affiliation: Department of Neuroradiology, Santa Clara Valley Medical Center, San Jose, California.
authors.forename: L P
authors.initials: LP
authors.lastname: Wood
authors.forename: M
authors.initials: M
authors.lastname: Parisi
authors.forename: I J
authors.initials: IJ
authors.lastname: Finch
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002493:Central Nervous System Diseases / Q000000981:diagnostic imaging*; D002648:Child; D003287:Contrast Media; D004630:Emergencies; D005260:Female; D006801:Humans; D007482:Iothalamate Meglumine; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media; D007482:Iothalamate Meglumine