A guide to imaging for common neurological problems

  title={A guide to imaging for common neurological problems},
  author={Adam B. Cohen and Joshua P. Klein and Srinivasan Mukundan},
  journal={BMJ : British Medical Journal},
#### Summary points Patients with headache, transient neurological episodes, symptoms after minor head trauma, and neck and low back pain often present to general practitioners and emergency room physicians. The examining doctor may be uncertain whether neurological imaging is needed. In this article, we discuss indications for imaging and tests that would be most useful in these scenarios. Table 1⇓ summarises our approach to this problem. Figure 1⇓ provides a walk through of representative… 
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Examinations of head computed tomography of 555 pediatric patients due acute neurological symptoms in Children’s Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos were analysed and 25% found abnormalities corresponded to referral indications.



Neuroimaging in the Evaluation of Patients with Non-Acute Headache

The proportion of patients with headache and intracranial lesions is relatively small, but neither neurological examination nor the features in the clinical history permit us to rule out such abnormalities.

Indications for computed tomography in patients with minor head injury.

A set of clinical criteria could be used to identify patients with minor head injury who do not need to undergo CT, and the use of CT can be safely limited to those who have certain clinical findings.

The Canadian CT Head Rule for patients with minor head injury

Does this patient with headache have a migraine or need neuroimaging?

Several individual clinical features were found to be associated with a significant intracranial abnormality, and patients with these features should undergo neuroimaging, and the presence of 4 simple historical features can accurately diagnose migraine.

Neuroimaging in trauma

CT and MRI are now the imaging techniques for acute and subacute brain injury, respectively, and Diffusion tensor imaging is being developed to provide more information on structural damage in brain injury.

Head trauma: comparison of MR and CT--experience in 100 patients.

CT remains the screening method of choice in evaluating acute severe head trauma; however, MR revealed additional clinically relevant findings in all four cases in which the patient's clinical symptoms were disproportionate to the CT findings.

Neck and low back pain: neuroimaging.

Diagnostic Evaluation of Low Back Pain with Emphasis on Imaging

Taking a history is more useful than physical examination in screening for underlying malignancy, at least in the early stages (Table 2) (7, 10).

Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury.

For patients with minor head injury and GCS score of 15, the Canadian CT Head Rule and the NOC have equivalent high sensitivities for need for neurosurgical intervention and clinically important brain injury, but the CCHR has higher specificity for important clinical outcomes than does the N OC, and its use may result in reduced imaging rates.

Incidental findings on brain MRI in the general population.

The prevalence of asymptomatic brain infarcts and meningiomas increased with age, as did the volume of white-matter lesions, whereas aneurysms showed no age-related increase in prevalence.