Head CT Not Useful for Evaluating Acute Dizziness in the ED

Magnetic resonance imaging has a higher diagnostic yield.

In a retrospective chart review, investigators determined the diagnostic yield (acute and subacute findings) of head computed tomography (CT) in 448 adult patients who presented to a single urban academic emergency department (ED) with acute dizziness (vertigo, lightheadedness, disequilibrium, presyncope).

The overall diagnostic yield of head CT was 2.2%, with emergent findings detected on only 1.6% of the scans. Of the 448 patients, 104 underwent follow-up imaging, most often with magnetic resonance imaging or angiography (MRI/A; 78.7%). Seventeen patients (13%) had findings on follow-up imaging that changed or confirmed the diagnosis; most of the changes in diagnosis were ischemic stroke that was not identified on initial CT. MRI was the follow-up modality that most often led to a change in diagnosis (16% of the time).

CITATION(S):

Lawhn-Heath C et al. Utility of head CT in the evaluation of vertigo/dizziness in the emergency department. Emerg Radiol 2013 Jan; 20:45.