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Predictors of Intracranial Path Findings in Pts Who Seek ER Care Because of Headache
Arch Neurol 54:1506-1509, Ramirez-Lassepas,M.,et al, 1997
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Article Abstract
Intracranial pathologic findings were found in 18(3.8%)of 468 patients. Acute onset and occipitonuchal location of headache,presence of associated symptoms,and patient age of 55 years or older were significantly associated with the finding of intracranial pathology,independently of the findings from neurologic examination.Abnormal findings on neurologic examination alone,whether focal or non-focal,had a highly significant association and a positive predictive value for intracranial pathology of 39%.Abnormal results from neurologic examination are the best clinical parameters to predict structural intracranial pathology;however,in patients 55 years or older with headache of acute onset located in the occipitonuchal region that has associated symptoms,computed tomographic scan of the head is justified as part of their clinical evaluation independently of the findings of the neurologic examination.
 
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