Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Aug 2018
ReviewEmergent Neuroimaging in the Oncologic and Immunosuppressed Patient.
Neuroimaging in the emergency department increasingly involves patients at increased risk for acute neurologic complications from malignancy and immunosuppression, including patients with organ transplantation, diabetes mellitus, treatment of chronic disease, and HIV positivity. These patients are susceptible to the same infections and emergencies as immunocompetent patients, but may present differently with common illnesses and are susceptible to a variety of other diseases. This article reviews important patient risk factors, emergent central nervous system abnormalities, and their imaging findings. Detailed knowledge of risk factors and specific complications in these complex patients is essential for optimal image acquisition, interpretation, diagnosis, and treatment.
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Maxillofacial injuries account for a large portion of emergency department visits and often result in surgical consultation. Although many of the principles of fracture detection and repair are basic, the evolution of technology and therapeutic strategies has led to improved patient outcomes. This article aims to provide a clinical review of imaging aspects involved in maxillofacial trauma and to delineate its relevance to patient management.
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Neuroimaging Clin. N. Am. · Aug 2018
ReviewBlunt Craniocervical Trauma: Does the Patient Have a Cerebral Vascular Injury?
Blunt cerebrovascular injury involves injury to the carotid and/or vertebral arteries sustained via generalized multitrauma or directed blunt craniocervical trauma. Stroke remains the most consequential outcome. ⋯ Discussion centers on the increasing reliance on multidetector computed tomography angiography for screening, considering relevant clinical criteria for determining screening. Imaging protocols, imaging findings, injury grading, pearls, and pitfalls are discussed.
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Computed tomography is often the first-line diagnostic imaging modality in the evaluation of patients with neurologic emergencies. A patient-centered approach to radiation dose management in emergent neuroimaging thus revolves around the appropriate use of computed tomography, including clinical decision support for ordering providers, thoughtful protocol design, the use of available technological advances in computed tomography, and radiation exposure monitoring at a population level. A multifaceted approach can help to minimize radiation exposure to individual patients while preserving diagnostic quality imaging.