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Nearly half of all emergency department (ED) visits in the United States result in some type of imaging study, a large number of which are performed for neurological complaints. Common presenting neurological complaints include headache, weakness, stroke, and trauma. Often the initial study performed for the evaluation of these complaints is an unenhanced computed tomography (CT) of the brain. However, as will be discussed below, certain presentations and clinical history can warrant magnetic resonance imaging (MRI) as a superior first-line imaging test. This chapter seeks to provide guidance in imaging modality selection and to discuss imaging findings in common clinical presentations to the ED. When pertinent, alternative and recommended follow-up studies are also discussed
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