Incidental Findings in Radiographic Imaging for Inpatients with Acute Ischemic Stroke

Background: Incidental findings on radiographic diagnostic imaging are a growing concern in the medical field. Little is known about the incidence and spectrum of incidental findings uncovered during stroke evaluations. Methods and Results: A random sample of 200 acute ischemic stroke admissions at an academic medical center was reviewed to better understand the incidence and spectrum of incidental findings on radiographic imaging studies obtained for a stroke evaluation. Among 200 stroke patients, 53 (26.5%) were found to have one or more incidental findings on radiographic imaging. Over 651 imaging studies, 69 incidental findings were uncovered, or 11 incidental findings per 100 imaging studies. Incidental findings were most commonly discovered within computerized tomography angiograms of the head and neck (n = 41 from of 176 studies). The most commonly identified incidental findings included thyroid nodules (n = 12), sinus disease (n = 11), pulmonary nodules (n = 10), and intracranial/cervical artery aneurysms (n = 5). Conclusions: Incidental findings are commonly found in patients undergoing an evaluation for acute ischemic stroke, some of which may be clinically relevant. Vascular neurologists and other clinicians caring for stroke patients may benefit from guidance on the management of expected incidental findings.