Despite recommendations not to perform imaging for patients with peripheral vertigo, up to one-fifth of patients had a head CT while in the ED.
One-fifth of patients in the Canadian province of Ontario who had peripheral vertigo received imaging that is not recommended in guidelines. This imaging was also associated with missed strokes, according to a study published in the journal Stroke.
Researchers from Toronto undertook a population-based retrospective cohort study to assess patients who were discharged from an emergency department (ED) after an index visit, with a diagnosis of peripheral vertigo. The goal was to determine the proportion of this patient population who underwent CT head imaging in the ED and to examine whether strokes were missed using CT imaging. The study took place from April 2006 to March 2011.
A total of 41,794 patients qualified. Of these, 8,596 patients (20.6%) received ED head CT imaging, and 99.8% of these patients were matched to a control.
The researchers compared the incidence of stroke within 30, 90, and 365 days subsequent to ED discharge between the patient and control groups.
“The relative risk of a 30- and 90-day stroke among exposed versus unexposed patients was 2.27 and 1.94, respectively,” the authors wrote. “There was no difference between groups at 1 year. Strokes occurred at a median of 32.0 days in exposed patients, compared with 105 days (interquartile range, 11.5–204.5) in unexposed patients.”
The authors concluded that although CT use among patients with peripheral vertigo is lower in Canadian EDs than in the United States, one fifth of patients discharged from an Ontario ED with peripheral vertigo had CT head imaging, despite published recommendations. “We found that CT imaging was associated with twice the number of early brain stem or cerebellar strokes after discharge from the ED,” they said.
Study with CT Data Suggests Women with PE Have More Than Triple the One-Year Mortality Rate than Men
April 3rd 2025After a multivariable assessment including age and comorbidities, women with pulmonary embolism (PE) had a 48 percent higher risk of one-year mortality than men with PE, according to a new study involving over 33,000 patients.
The Reading Room: Racial and Ethnic Minorities, Cancer Screenings, and COVID-19
November 3rd 2020In this podcast episode, Dr. Shalom Kalnicki, from Montefiore and Albert Einstein College of Medicine, discusses the disparities minority patients face with cancer screenings and what can be done to increase access during the pandemic.
Predicting Diabetes on CT Scans: What New Research Reveals with Pancreatic Imaging Biomarkers
March 25th 2025Attenuation-based biomarkers on computed tomography (CT) scans demonstrated a 93 percent interclass correlation coefficient (ICC) agreement across three pancreatic segmentation algorithms for predicting diabetes, according to a study involving over 9,700 patients.
Can Photon-Counting CT be an Alternative to MRI for Assessing Liver Fat Fraction?
March 21st 2025Photon-counting CT fat fraction evaluation offered a maximum sensitivity of 81 percent for detecting steatosis and had a 91 percent ICC agreement with MRI proton density fat fraction assessment, according to new prospective research.