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Brain CT requests from emergency department: reality.

M Novoa Ferro1, E Santos Armentia1, N Silva Priegue1

  • 1Hospital Povisa, Servicio de Radiodiagnóstico, Vigo, Pontevedra, España.

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|November 2, 2020
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Summary

Most emergency department brain CT scans, often requested for head trauma or neurological symptoms, reveal no acute pathology. This indicates overuse, leading to unnecessary patient radiation exposure and increased workload.

Keywords:
BrainCerebralComputed tomographyCráneoDose of radiation.Dosis de radiaciónEmergency departmentHeadNeuroimagenNeuroimagingTomografía computarizadaUrgencias

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Area of Science:

  • Radiology
  • Emergency Medicine
  • Neuroradiology

Background:

  • Brain CT scans are frequently requested in emergency departments.
  • Understanding the indications and diagnostic yield is crucial for optimizing resource allocation.
  • Evaluating the prevalence of acute pathology in this setting is essential.

Purpose of the Study:

  • To determine the primary reasons for urgent brain CT requests in the emergency department.
  • To assess the incidence of acute pathological findings in patients undergoing brain CT.
  • To analyze the diagnostic yield of brain CT for common emergency presentations.

Main Methods:

  • Retrospective review of 507 urgent brain CT studies performed in October-November 2018.
  • Data collected included patient demographics, indication for CT, findings, contrast use, and comparison with prior studies.
  • Statistical analysis was performed using SPSS.

Main Results:

  • Head trauma was the most common indication (40.5%), with only 15.6% showing acute intracranial lesions.
  • Focal neurological symptoms accounted for 16% of requests, with 16% revealing ischemic infarcts or bleeding.
  • No pathological findings were reported in 43.2% of studies; small vessel disease was the most frequent abnormality (20%).

Conclusions:

  • A significant proportion of emergency department brain CT scans do not reveal findings that alter patient management.
  • The current utilization patterns suggest potential overuse of urgent brain CT.
  • Overutilization contributes to increased workload and unnecessary radiation exposure for patients.