Reinus W R, Wippold F J, Erickson K K
Department of Radiology, Jewish Hospital, St Louis, Missouri.
Ann Emerg Med. 1993 Aug;22(8):1298-303. doi: 10.1016/s0196-0644(05)80111-8.
We evaluated the need for emergency noncontrast cranial computed tomography (CT) among patients presenting to an emergency department with a complaint of seizure.
We retrospectively evaluated the medical records of 115 consecutive patients who presented to a trauma Level I ED with a complaint of seizure and underwent a noncontrast cranial CT.
Sixty patients had a known seizure disorder, 38 had new-onset seizure, and 17 had possible seizure. The results of the neurologic examination and CT could be compared in 105 of the patients. An abnormal neurologic examination predicted 19 of 20 positive CT scans (95%) and demonstrated a strong association with CT results (P < .00004). Only a history of malignancy correlated to CT findings (P < .008). No other catalogued variable showed a statistical relationship with CT findings.
Our data suggest that patients with either a history of malignancy or an abnormal neurologic examination at the time of examination in the ED will derive the greatest benefit from emergency CT.
我们评估了因癫痫发作而前往急诊科就诊的患者进行急诊非增强头颅计算机断层扫描（CT）的必要性。
我们回顾性评估了115例连续因癫痫发作前往一级创伤急诊科就诊并接受非增强头颅CT检查的患者的病历。
60例患者有已知的癫痫疾病，38例为新发癫痫，17例可能为癫痫发作。105例患者的神经学检查结果和CT结果可进行比较。异常的神经学检查预测了20例阳性CT扫描中的19例（95%），并显示出与CT结果有很强的相关性（P <.00004）。只有恶性肿瘤病史与CT结果相关（P <.008）。没有其他分类变量显示与CT结果有统计学关系。
我们的数据表明，在急诊科就诊时，有恶性肿瘤病史或神经学检查异常的患者将从急诊CT中获得最大益处。
