Department of Emergency Medicine, Tepecik Training and Research Hospital, Turkey.
Department of Emergency Medicine, Tepecik Training and Research Hospital, Turkey.
Am J Emerg Med. 2019 Feb;37(2):228-230. doi: 10.1016/j.ajem.2018.05.033. Epub 2018 May 16.
Diagnostic tests are widely used for patients with syncope in the emergency department (ED). This study aimed to determine the diagnostic yield of neuroimaging in patients with syncope without high-risk symptoms.
Adult patients who presented to the ED with syncope in 2016 were screened retrospectively. Patients who suffered from mild head trauma due to syncope were also included. Patients with neurological examination findings (confusion, amnesia, focal neurological deficit, severe headache, dizziness, nausea and vomiting), patients on anticoagulants, patients with known intracranial malignancies and those whose loss of consciousness was attributed to reasons other than syncope were excluded from the study.
A total of 1114 patients were included in the study. The median age was 48 years (IQR = 34-66 years) and 576 (51.7%) of the patients were male. The neuroimaging tests performed were cranial computerized tomography (CT) in 694 (62.3%) cases and magnetic resonance imaging (MRI) in 114 (10.2%) cases. Mild head trauma due to syncope was observed in 116 (10.4%) patients. None of the neuroimaging studies revealed any clinically significant findings.
Neuroimaging is not beneficial in patients whose medical history and physical examination do not indicate neurogenic syncope, even if the patient has mild head trauma.
在急诊科（ED），诊断性检查被广泛用于诊断晕厥患者。本研究旨在确定无高危症状的晕厥患者神经影像学检查的诊断效果。
回顾性筛选了 2016 年在急诊科因晕厥就诊的成年患者。因晕厥导致轻度头部外伤的患者也包括在内。排除有神经检查发现（意识模糊、遗忘、局灶性神经功能缺损、剧烈头痛、头晕、恶心和呕吐）、正在使用抗凝药物、已知颅内恶性肿瘤或意识丧失归因于晕厥以外的其他原因的患者。
共纳入 1114 例患者。患者中位年龄为 48 岁（IQR=34-66 岁），576 例（51.7%）为男性。进行的神经影像学检查包括颅脑计算机断层扫描（CT）694 例（62.3%）和磁共振成像（MRI）114 例（10.2%）。116 例（10.4%）患者因晕厥导致轻度头部外伤。所有神经影像学研究均未发现任何有临床意义的发现。
即使患者有轻度头部外伤，如果病史和体格检查不提示神经源晕厥，神经影像学检查对患者也无益处。
