Neuroimaging clinics of North America
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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.
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Neuroimaging Clin. N. Am. · Aug 2018
ReviewApproach to Imaging in Patients with Spontaneous Intracranial Hemorrhage.
Spontaneous intracranial hemorrhage is a commonly encountered neurologic emergency. Imaging plays important roles in both guiding the emergent stabilization of patients with ICH and in elucidating the etiology of the hemorrhage to prevent rebleeding. A thorough understanding of the factors that have an impact on immediate management, the causes of hemorrhage, and the strengths of various imaging techniques in addressing these 2 concerns is vital to crafting a patient-centered approach to this condition.
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Neuroimaging Clin. N. Am. · Aug 2018
ReviewThe Adult Patient with Acute Neurologic Deficit: An Update on Imaging Trends.
Stroke is the clinical syndrome of abrupt onset of acute neurologic deficit owing to decreased oxygen delivery to the brain, resulting in ischemia or infarction. Approximately 87% of strokes are ischemic and 13% are hemorrhagic. Improved awareness of the neuroimaging findings highlighted in recent stroke clinical trials, as well as of their role in patient selection for novel treatment options-including "late window" (8-24 hours post-ictus!) intraarterial thrombectomy-has become increasingly important. This article focuses on the role of neuroimaging in the assessment and management of patients with acute ischemic stroke.
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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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Neuroimaging Clin. N. Am. · Aug 2018
ReviewEmergent Neuroimaging During Pregnancy and the Postpartum Period.
Acute neurologic emergencies in pregnancy often require neuroimaging to guide diagnosis and treatment. Implementation of a patient-centered care model in radiology can alleviate a patient's stress, reinforce appropriate imaging workup, improve patient satisfaction, and lead to improved outcomes. The authors present the evaluation, differential diagnosis, and recommended imaging protocols for the three most common acute neurologic symptoms in pregnancy and the postpartum period: headache, seizure, and focal neurologic deficits. With the patient's symptoms as a reference point, the referring physician in consultation with the radiologist can effectively implement the optimal imaging procedures.