Daniel M. Lindberg, MD reviewing Reynolds AS et al. Resuscitation 2017 Jan 3.

Many computed tomography scans showed abnormalities in this retrospective study, but it's not clear that performing early head CT improved care.

Neurological emergencies can result in cardiac arrest, and neurological injury can occur as a result of cardiac arrest. These authors retrospectively assessed the utility of head computed tomography (CT) in patients with out-of-hospital cardiac arrest who survived for at least 24 hours at a single academic center from 2007 to 2015.

Of 213 patients in the analysis, 115 (54%) underwent head CT within 24 hours. In 43 patients (20% of all patients; 37% of those who underwent head CT), head CT showed abnormalities, such as loss of gray-white differentiation, global cerebral edema, and ischemic stroke. The authors note that head CT findings led to changes in management in 15 patients. These changes included transfer to the neurological intensive care unit, repeat head CT, and neurosurgical consultation alone; only one patient underwent neurological surgery. Of patients for whom CT findings changed management, only one survived, in a persistent vegetative state.

CITATION(S):

Reynolds AS et al. Use of early head CT following out-of-hospital cardiopulmonary arrest. Resuscitation 2017 Jan 3; [e-pub].

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