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To determine the value of performing contrast CT in addition to non- contrast CT in the evaluation of acute non-traumatic central nervous system disorders,we retrospectively reviewed 322 cases originating from the emergency room at our institution.The most common indication for scanning was seizure activity(34%of total),followed by headache(30%),focal neurological deficit(10%),and altered mental status(8%).75%of the non- contrast scans were normal The contrast-enhanced scan revealed abnormalities not evident on the non-contrast scan in only three of these cases,and the information did not alter patient management.We conclude that in the acute setting,if a non-contrast CT is normal,a contrast study is usually unnecessary.Therefore,given the additional risks of contrast infusion,the contrast study,if needed,is generally best obtained at a later date,after more careful evaluation of the patient's history and medical records.If the non-contrast CT scan is abnormal,a contrast enhanced CT scan may be beneficial,but,again,is often not needed to direct acute patient management. |
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