Items in AFP with MESH term: Tomography, X-Ray Computed

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Headache - Photo Quiz


Intestinal Obstruction in an Octogenarian - Photo Quiz


A Healthy Woman with Right Upper Quadrant Discomfort on Deep Palpation - Photo Quiz


Computed Tomography After Minor Head Injury - Point-of-Care Guides


Soft Tissue Mass over Right Brow - Photo Quiz


Is There Benefit to Coronary Calcium Screening? - Editorials


New-Onset Seizures - Photo Quiz


Multiple Pulmonary Nodules - Photo Quiz


Acute Stroke Diagnosis - Article

ABSTRACT: Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of ischemic stroke diagnosis. The most common presenting symptoms for ischemic stroke are difficulty with speech and weakness on one half of the body. Many stroke mimics exist; two of the most common are a postictal seizure and hypoglycemia. Taking a detailed history and performing ancillary testing will usually exclude stroke mimics. Neuroimaging is required to differentiate ischemic stroke from intracerebral hemorrhage, as well as to diagnose entities other than stroke. The choice of neuroimaging depends on its availability, eligibility for acute stroke interventions, and the presence of patient contraindications. Subarachnoid hemorrhage presents most commonly with severe headache and may require analysis of cerebrospinal fluid when neuroimaging is not definitive. Public education of common presenting stroke symptoms is needed for patients to activate emergency medical services as soon as possible after the onset of stroke.


Radiologic Evaluation of Suspected Renovascular Hypertension - Article

ABSTRACT: More than 72 million Americans have hypertension, and the majority of these persons have essential hypertension. However, a significant subset has a secondary cause. The most common cause of secondary hypertension is renal vascular hypertension, of which renal artery stenosis is the leading pathology. Up to 5 percent of all occurrences of hypertension are caused by renal artery stenosis, equating to as many as 3.5 to 4 million occurrences in the United States. Detecting renal artery stenosis is particularly important for ensuring that this potentially curable form of hypertension is identified and treated properly. Duplex Doppler ultrasonography is a good screening test in many patients, but it has limitations in larger persons and can overlook small accessory arteries. For patients with normal renal function but a high clinical index of suspicion for renovascular disease, contrast-enhanced magnetic resonance angiography and computed tomographic angiography are the most accurate imaging tests. For patients with diminished renal function, gadolinium-enhanced contrast magnetic resonance angiography is the best imaging test. However, caution is warranted because exposure to gadolinium contrast agents is associated with nephrogenic systemic fibrosis in patients with renal failure. The American College of Radiology has developed appropriateness criteria for imaging tests related to the diagnosis of renal artery stenosis. This article is a summary of the recommendations, with the advantages and limitations of each test.


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