Title: Neuroimaging in Syncope - Is It Necessary?<br/>Author: WanTsu Wendy Chang<br/><a href='http://umem.org/profiles/faculty/1322/'>[Click to email author]</a><hr/><ul>
        <li>
                <span style="font-size:14px;">The use of neuroimaging in syncope-related ED visits increased from 21% in 2001 to 45% in 2010.</span></li>
        <li>
                <span style="font-size:14px;">A recent single-center retrospective study of 1114 patients who presented to the ED with syncope found that 62.3% patients underwent CT, while 10.2% underwent MRI.</span></li>
        <li>
                <span style="font-size:14px;">A subset of patients (10.4%) sustained mild head trauma (GCS 14-15) due to syncope and all received neuroimaging.</span></li>
        <li>
                <span style="font-size:14px;">Neuroimaging studies were <u>not</u> found to be beneficial in patients without features of:</span>
                <ul>
                        <li>
                                <span style="font-size:14px;">Confusion</span></li>
                        <li>
                                <span style="font-size:14px;">Amnesia</span></li>
                        <li>
                                <span style="font-size:14px;">Focal neurological deficit</span></li>
                        <li>
                                <span style="font-size:14px;">Dizziness</span></li>
                        <li>
                                <span style="font-size:14px;">Severe headache</span></li>
                        <li>
                                <span style="font-size:14px;">Nausea and vomiting</span></li>
                        <li>
                                <span style="font-size:14px;">Signs of serious head injury</span></li>
                        <li>
                                <span style="font-size:14px;">Intracranial malignancies</span></li>
                        <li>
                                <span style="font-size:14px;">Use of anticoagulant drugs</span></li>
                </ul>
        </li>
</ul>
<p>
        <span style="font-size:14px;"><u>Bottom Line</u>: Consider obtaining neuroimaging in patients presenting with syncope only if clinical features suggest probable neurological syncope.</span></p>
<fieldset><legend>References</legend>

                <p style="margin: 0px; padding: 0px; border: 0px; line-height: 1.57143em;">
         </p>
<ul>
        <li>
                Idil H, Kilic TY. Diagnostic yield of neuroimaging in syncope patients without high-risk symptoms indicating neurological syncope. <em>Am J Emerg Med</em>. 2018 May 16 [Epub ahead of print]</li>
        <li>
                Probst MA, Kanzaria HK, Gbedemah M, Richardson LD, Sun BC. National trends in resource utilization associated with ED visits for syncope. <em>Am J Emerg Med</em>. 2015;33(8):998-1001.</li>
</ul>
<p style="margin: 0px; padding: 0px; border: 0px; line-height: 1.57143em; text-align: center;">
        <em><strong>Follow me on Twitter @EM_NCC</strong></em></p>
</fieldset>