HALIFAX, N.S. — Emergency physicians don't miss many clinically significant findings on computerized axial tomography scans of the head.
Neuroradiologists agreed with the CT interpretations made by emergency department physicians almost all of the time, Dr. Abdullah Al-Reesi reported in a poster presented at the 11th International Conference on Emergency Medicine.
Dr. Al-Reesi, of the University of Ottawa, reviewed 442 consecutive CT head scans done in an emergency department over a 5-month period, comparing the interpretations done by both groups of physicians.
Indications for CT were head injury, headache, seizure, confusion, decreased consciousness, cerebrovascular accident, transient ischemic attack, and dizziness.
ED physicians missed three clinically significant lesions: two nontraumatic and one traumatic subarachnoid hemorrhages. They also missed six clinically nonsignificant findings, which included one small (less than 5 mm) cerebral contusion, three cases of fluid in the sinuses, one small lacunar infarct, and one patchy hypodensity later identified as a multiple sclerosis lesion. A patient with an intraventricular hemorrhage was discharged home. Once the error was recognized, he was referred for emergency neurosurgical consult.
