P108 – 2408: Use of the cranial computed tomography in children with acute neurological complaints at the Pediatric Emergency Department

Objective The objective of this study is to determine the prevalance, indications, aid to the diagnosis and the treatment and the excessive and irrelevant use of the cranial computed tomography (CCT) in children with acute neurological complaints. Methods The records of the patients, who presented to Pediatric Emergency Department of Gazi University Medical Faculty between June 2012 to June 2013 with acute neurological complaints and had CCT, were reviewed retrospectively. Results During one year, 34.575 patients were admitted to our emergency department. Ranging in age from one month to eighteen years, 146 girls and 240 boys, 460 had CCT scan, 386 patients were included. The indications for CCT are trauma 78.4%, seizure 6.9%, unconsciousness 4.1%, headache 3.1% and the others 7.2% respectively. The results of CCT scans of 156 40.4% were reported abnormal (110 of these patients have significant findings such as brain edema, fractures and/or haemorrhage). MRI scan was performed to 27 of these patients who has normal CCT, 11 of them parenchymal haemorrhage, axonal damage, mass, sinusitis, ventricular dilatation and gliotic signal changes were reported. Only 120 (31%) patients were hospitalized and 11 (2.8%) of them had emergent neurosurgical intervention. Conclusion Although CCT is still commonly used in the evaluation of acute neurological conditions at pediatric emergency departments, the number of patients who have urgent neurosurgical intervention is very low. As a result, if CCT scan is not supported with clinical findings and neurological examination, the use of CCT scan can be excessive and irrelevant.