• The use of neuroimaging in syncope-related ED visits increased from 21% in 2001 to 45% in 2010.
• A recent single-center retrospective study of 1114 patients who presented to the ED with syncope found that 62.3% patients underwent CT, while 10.2% underwent MRI.
• A subset of patients (10.4%) sustained mild head trauma (GCS 14-15) due to syncope and all received neuroimaging.
• Neuroimaging studies were not found to be beneficial in patients without features of:
  • Confusion
  • Amnesia
  • Focal neurological deficit
  • Dizziness
  • Severe headache
  • Nausea and vomiting
  • Signs of serious head injury
  • Intracranial malignancies
  • Use of anticoagulant drugs

Bottom Line: Consider obtaining neuroimaging in patients presenting with syncope only if clinical features suggest probable neurological syncope.

References

 

• Idil H, Kilic TY. Diagnostic yield of neuroimaging in syncope patients without high-risk symptoms indicating neurological syncope. Am J Emerg Med. 2018 May 16 [Epub ahead of print]
• Probst MA, Kanzaria HK, Gbedemah M, Richardson LD, Sun BC. National trends in resource utilization associated with ED visits for syncope. Am J Emerg Med. 2015;33(8):998-1001.

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