ST EMLYN´S
St Emlyn’s - By Simon Carley - December 6, 2021
…”Our current strategy of investigation for ambulant patients with concerning presentations is to perform a CT scan of the brain. If that is negative, or if the CT scan was taken over 6 hours from symptom onset our default position is to then perform a lumbar puncture. In reality that often means a shared decision making process with the patient as we know that the yield of positive outcomes from the LP is very low in this group of patients and many patients elect not to proceed.
The data that underpins this approach has changed over the years, largely as a result of the improved performance of CT scanners, and probably of the radiologists who interpret them. Back in 2015 @cgray reviewed the evidence and concluded that a CT scan effectively excluded an SAH using some of the more recent scanner technologies and appropriate reporting, but have things improved since then?
This week we review a paper that might help us answer this question based on more recent data. The abstract is below but as we always say, please read the full paper for yourself and come to your own conclusions…”