Clinical Decision Instrument of Isenberg et al for Emergency Brain CT for an Adult with Status Epilepticus

Patient selection: status epilepticus, age >= 18 years

High-risk conditions:

(1) history of intracranial hemorrhage

(2) malignancy

(3) immunosuppression (AIDS, chronic corticosteroids, biologic agents)

(4) head trauma

Patients receiving anticoagulants who had an acute finding on brain CT had one or more of the high-risk conditions.

Positive findings on CT include:

(1) hemorrhage or hematoma

(2) intracranial contusion

(3) cerebral edema

(4) anoxia

(5) new ischemic changes

(6) herniation or midline shift

(7) new hydrocephalus

Performance:

• The sensitivity was 88% and specificity 87%.

• The negative predictive value was 99.5%.