engleski

Computed tomography in emergency department in patients with headache without focal neurological abnormalities

Introduction. Headache is a common reason for presentation in emergency department (ED). The aim of this research was to determine the incidence of positive computed tomography (CT) fi ndings in patients with headache without focal neurological abnormalities in ED. Material and methods. The results of the native CT scans in ED were retrospectively analyzed. Exclusion criteria included: focal neurological abnormalities, previous head trauma, underlying malignancy, brain metastasis, previous brain operation, dizziness, fever, nausea, vomiting, coagulopathy. As a clinically signifi cant fi nding we took into account tumours, hemorrhage and acute ischemic lesion. 108 patients met these criteria. The age range was from 18 to 87 years, with mean of 49.5 years, 63% of the patients were female and 37% were male. Results. Normal CT fi ndings were found in 82 patients (75.9%). 26 patients (24.1%) had pathological fi ndings, out of that number 17 (15.7%) fi ndings were clinically irrelevant and 9 (8.3%) were clinically signifi cant. Out of the 9 clinically signifi cant fi ndings, tumor process was found in 5 (4.6%) patients, hemorrhage was found in 3 (2.8%) patients and ischemic lesion was found in 1 (0.9%) patient. In two patients with hemorrhage a subarachnoid hemorrhage was found, with an incidence of 1.8%. All of the 9 clinically signifi cant fi ndings were further evaluated by MR and/or CT angiography and in 2 cases there was a change in initial CT diagnosis but without any change in the category of outcome. Conclusions. Our research revealed 8.3% of clinically signifi cant emergency examinations in patients with headache without focal neurological abnormnalities.

headache, emergency department, computed tomography (CT)

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