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Emergency Medicine Journal 2008;25:290-291; doi:10.1136/emj.2008.059410
© 2008 BMJ Publishing Group Ltd and the College of Emergency Medicine.

BEST EVIDENCE TOPIC REPORTS

BET 4. COMPUTED TOMOGRAPHIC ANGIOGRAPHY FOR DETECTION OF SUBARACHNOID HAEMORRHAGE

Ayan Sen, Clinical Fellow, Intensive Care/Emergency Medicine, Shweta Gidwani, Clinical Effectiveness Fellow, Craig Ferguson, Clinical Effectiveness Fellow

Manchester Royal Infirmary, Manchester, UK

The first 150 words of the full text of this article appear below.

Report by Ayan Sen, Clinical Fellow, Intensive Care/Emergency Medicine

Search checked by Shweta Gidwani and Craig Ferguson, Clinical Effectiveness Fellows

Institution: Manchester Royal Infirmary, Manchester, UK

Three-part question

In [patients with clinical suspicion of subarachnoid haemorrhage] is [CT Angiography better than non-contrast CT and lumbar puncture] in [detection]?

Clinical scenario

A 41-year-old man comes to the Emergency Department complaining of a sudden onset of excruciating headache with photophobia and episodes of vomiting.He is afebrile and has a blood pressure of 180/110 mm Hg. You are worried he may have a subarachnoid haemorrhage (SAH) and arrange an urgent computed tomography (CT) scan.The radiologist kindly agrees to it and reports no haemorrhage seen on a non-contrast CT head scan. He is still symptomatic and gets admitted for a lumbar puncture. You have heard about computed tomographic angiography (CTA) as a primary diagnostic study for SAH and wonder if this should have been the . . . [Full text of this article]


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