Role of noncontrast head CT in the assessment of vascular abnormalities in the emergency room

Nontraumatic brain parenchymal hemorrhage: The usual suspects and more

Brain parenchymal hemorrhage is a common neuroimaging finding in an emergency room. It is considered primary in the absence of an underlying lesion or coagulopathy. Secondary hemorrhages are caused by various structural causes and pathologies. The goals of imaging are to identify the hematoma, assess factors that have prognostic significance, assess associated complications, identify an underlying etiology whenever possible, and guide therapeutic decisions. The review provides an illustrative review of various etiologies of non-traumatic brain parenchymal hemorrhage and their imaging evaluation.

Brain computerized tomography reading in suspected acute ischemic stroke patients: what are essentials for medical students?

BACKGROUND

Few systematic methods prioritize the image education in medical students (MS). We hope to develop a checklist of brain computerized tomography (CT) reading in patients with suspected acute ischemic stroke (AIS) for MS and primary care (PC) physicians.

METHODS

Our pilot group generated the items indicating specific structures or signs for the checklist of brain CT reading in suspected AIS patients for MS and PC physicians. These items were used in a modified web-based Delphi process using the online software "SurveyMonkey". In total 15 panelists including neurologists, neurosurgeons, neuroradiologists, and emergency department physicians participated in the modified Delphi process. Each panelist was encouraged to express feedback, agreement or disagreement on the inclusion of each item using a 9-point Likert scale. Items with median scores of 7-9 were included in our final checklist.

RESULTS

Fifty-two items were initially provided for the first round of the Delphi process. Of these, 35 achieved general agreement of being an essential item for the MS and PC physicians. The other 17 of the 52 items in this round and another two added items suggested by the panelists were further rated in the next round. Finally, 38 items were included in the essential checklist items of brain CT reading in suspected AIS patients for MS and PC physicians.

CONCLUSIONS

We established a reference regarding the essential items of brain CT reading in suspected AIS patients. We hope this helps to minimize malpractice and a delayed diagnosis, and to improve competency-based medical education for MS and PC physicians.