An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa
SA j. radiol
;
26(1): 1-7, 2022.
Article
in English
| AIM
| ID: biblio-1354430
ABSTRACT
Background:
Globally, adults presenting with seizures account for 1% 2% of visits to emergency departments (EDs), of which 25% are new-onset seizures. Neuroimaging is essential as part of the initial workup. Multiple studies have demonstrated abnormal CT brain (CTB) findings in these patients.Objectives:
To review the CTB findings in adults presenting with new-onset seizures in a resource restricted setting.Method:
A retrospective review of 531 CTBs was conducted at a tertiary hospital in Gauteng on adults presenting to the ED with new-onset seizures.Results:
The mean age of the patients was 45.6 ± 17.1 years, and the male to female ratio was 1.21. Generalised and focal seizure types were almost equally represented. Of the total 531 patients, 168 (31.6%) were HIV positive. The CTB findings were abnormal in 257 (48.4%) patients, albeit vascular pathology accounted for 21.9%. Infective pathology accounted for 14.1% with a statistically significant association with HIV (p = 0.003). Trauma related pathology was 2.4%, whilst neoplastic pathology was seen in 3.0%. Other causes included congenital pathology, calcifications, atrophy and gliosis. Clinical factors associated with abnormal CTB findings were age ≥ 40 years, HIV infection, hypertension, focal seizures, low Glasgow Coma Scale (GCS), raised cerebrospinal fluid (CSF) protein and presence of lymphocytes.Conclusion:
A high yield of abnormal CTB findings was noted in adult patients who presented with new-onset seizures, supporting the use of urgent CTB in patients with certain clinical risk factors. Patients without these risk factors can be scanned within 2448 h in a resource restricted setting.
Full text:
Available
Index:
AIM (Africa)
Main subject:
Seizures
/
Brain
/
Medical Audit
Type of study:
Risk factors
Limits:
Adult
/
Humans
Language:
English
Journal:
SA j. radiol
Year:
2022
Type:
Article
Institution/Affiliation country:
Department of Radiology, Faculty of Health Sciences, Chris Hani Baragwanath Hospital, University of the Witwatersrand/ZA
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