Recent research on transient ischemic attacks (TIA) has changed how emergency medicine providers evaluate and manage this sometimes difficult diagnosis. This article provides readers with current information and relevant studies pertaining to TIAs.
SYNOPSIS: The diagnosis of primary headache disorders by a computerized and clinical paradigm can predict a baseline prevalence of intracranial abnormalities on brain imaging. Some historical “red flags” in children with headaches, including morning headaches and occipital pain, are not associated with increased intracranial abnormalities.
The use of amyloid positron emission tomography scanning to assist in accurate diagnosis of patients with symptoms of cognitive impairment as well as frank dementia results in a change of diagnosis in at least 25% of patients.
Older adults present unique challenges for the clinician. Missing a spinal fracture can have devastating consequences for this more fragile population. The authors review the clinical presentation, injury patterns, and unique considerations for imaging and management of spinal fractures in older adults.
tau PET imaging shows progression of brain Alzheimer’s pathology over time and correlates with cognitive impairment better than amyloid PET. In future clinical trials, tau PET can serve as a biomarker for Alzheimer’s disease progression.
The investigators retrospectively evaluated ESCMIID, IDSA, and Swedish guidelines for neuroimaging in 815 adults with acute bacterial meningitis. Swedish guidelines omit altered mental status and immunosuppression as indications for imaging prior to lumbar puncture. Adherence to Swedish guidelines resulted in decreased mortality and more favorable outcomes.
A meta-analysis of 142 studies demonstrated that functional imaging studies in Parkinson’s disease using tracers for aromatic acid decarboxylase showed smaller defects compared to those using tracers targeting dopamine transport and VMAT2. Symptom severity correlated linearly with dopamine neuron loss as determined by these imaging studies.
Any clinician who may have a role in the initial triage and management of these patients would be well-served to have an understanding of the currently available imaging modalities and techniques, and the applications of each in the evaluation of acute ischemic stroke.
These articles are based on the editor's personal interactions as a participant at the International Stroke Conference in Houston, Feb. 22-24, 2017. All interpretations and opinions are exclusively those of the editor.