The Importance of Neurological Examination for the Indication of Computed Tomography of the Brain in Pediatric Emergency Room

Özet

Objectives: In this study, records of the children who underwent Computed Tomography of the Brain (CTB) were reviewed toincrease the awareness of pediatricians to protect patients from radiation, whether CTB was used with right indications or if it wasdeterminative for diagnosis.Methods: In total, in this study, 342 cases applied to our Pediatric Emergency Polyclinic between January 2005-December 2010were retrospectively evaluated regarding complaints at admission, neurological examination and CTB results. The sensitivity andspecificity of the neurological examination in detecting the CTB pathology was determined.Results: The results were normal in 319 of the 342 cases with CBT and abnormal in 23, out of which abnormal CTB results were onlyin three (0.99%) of the 301 patients with normal neurological examination results and in 20 (48.8%) of 41 patients with abnormalneurological examination results. The difference between the two groups was statistically significant (p=0.001). The sensitivity andspecificity of the neurological examination in detecting CTB pathology were 87% and 94%, respectively.Conclusion: Detailed neurological examination of the patients in the pediatric emergency department has a key role in determiningthe indications for CTB. Clinical follow-up should guide neuroradiological imaging in children with normal results of theneurological examination.