Can the combination of a negative computed tomography result and a negative lumbar puncture safely exclude the diagnosis of subarachnoid hemorrhage in patients with thunderclap headache?
نویسندگان
چکیده
CLINICAL QUESTION How many patients who had a negative computed tomography and lumbar puncture result on initial evaluation were diagnosed with subarachnoid hemorrhage in the subsequent 6 months to 3 years? ARTICLE CHOSEN Perry J, Spacek A, Forbes M, et al. Is the combination of negative computed tomography result and negative lumbar puncture result sufficient to rule out subarachnoid hemorrhage? Ann Emerg Med 2008;51:707-13. OBJECTIVE To determine the sensitivity of both a negative computed tomography and a negative lumbar puncture in ruling out subarachnoid hemorrhage.
منابع مشابه
Thunderclap headache: CT and lumbar puncture but occasionally more!
In considering thunderclap headache, the immediate need is to exclude the possibility of subarachnoid hemorrhage. Both our protagonists agree on this point, that the minimum required is to perform a plain brain CT and, if there is no evidence of hemorrhage, lumbar puncture. We agree with Moussouttas and Mayer that spectrophotometry to detect xanthochromia should be mandatory. It is at this poin...
متن کاملNontraumatic subarachnoid hemorrhage in the setting of negative cranial computed tomography results: external validation of a clinical and imaging prediction rule.
STUDY OBJECTIVE Clinical variables can reliably exclude a diagnosis of nontraumatic subarachnoid hemorrhage in patients with negative cranial computed tomography (CT) results. We externally validated 2 decision rules with 100% reported sensitivity for a diagnosis of subarachnoid hemorrhage, among patients undergoing lumbar puncture after a negative cranial CT result: (1) clinical rule: presence...
متن کاملIs lumbar puncture still needed in suspected subarachnoid hemorrhage after a negative head computed tomographic scan?
CLINICAL QUESTION Is lumbar puncture still needed in suspected subarachnoid hemorrhage with a negative head computed tomographic scan performed within 6 hours of headache onset? ARTICLE CHOSEN Perry JJ, Stiell IG, Sivilotti ML, et al. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011...
متن کاملA pilot survey of decisions by acute medicine staff after thunderclap headache.
INTRODUCTION AND AIMS Traditionally, neurologically pristine patients with a thunderclap headache are investigated with a non-contrast computed tomography (CT) brain scan, which if negative is followed by a lumbar puncture (LP) to exclude important secondary causes, particularly subarachnoid haemorrhage (SAH). However, misdiagnosis of such patients is still a cause of significant human and fina...
متن کاملSubarachnoid Hemorrhage.
Aneurysmal subarachnoid hemorrhage (SAH) is a neurological emergency with high risk of neurological decline and death. Although the presentation of a thunderclap headache or the worst headache of a patient's life easily triggers the evaluation for SAH, subtle presentations are still missed. The gold standard for diagnostic evaluation of SAH remains noncontrast head computed tomography (CT) foll...
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ورودعنوان ژورنال:
- CJEM
دوره 15 2 شماره
صفحات -
تاریخ انتشار 2013