Mustafa Fatih ERKOÇ, Hakan İMAMOĞLU, Ahmet Bilal DOSTBİL, Aylin OKUR

Is cranial ct really required ın the emergency department for eachpatient with headache?

Amaç: Baş ağrısı acil serviste sık görülen bir yakınmadır. Baş ağrısı birçok etiyolojik sebebe bağlı olabilir ve acil ser- vis hekimi tarafından doğru bir ayırıcı tanı yapmak önemlidir. Ancak günümüzde acil servise baş ağrısı şikayeti ilegelen her hastaya kraniyel bilgisayarlı tomograf (BT) tetkiki yapılması neredeyse bir kural haline gelmiştir. Bu çalış- mada acil servise baş ağrısı şikayeti ile gelen her hastaya kraniyel BT nin gerçekten gerekli olup olmadığını bulmayıayrıca kraniyel BT tetkiki yaparken hasta seçiminin önemine dikkat çekmeyi hedefedik. Yöntem ve Gereçler: 1 yıllık süreçte retrospektif bir çalışma yapıldı. Hastanemiz acil servisine baş ağrısı şikayeti ilegelen toplamda 3567 hastanın kraniyel BT leri çalışmaya dahil edildi. BT sonuçları acil patolojiler açısından değer- endirildi. Bulgular: Kraniyel BT si değerlendirilen 3567 hastanın sadece 42 (1.17 %1.17)sinde acil patoloji saptandı. Geriyekalan hastalarda hiçbir acil patoloji izlenmedi.Sonuç: Acil servise baş ağrısı ile başvuran hastalarda acil kraniyal BT yöntemi ayırıcı tanı ve ek patolojilere yönelikolarak önemli bulgular sunabilir ancak hastaların çoğunluğunda etkin ve dikkatli bir nörolojik muayene ile BT ye olanihtiyaç dışlanılabilir. Bu yolla hastaları gereksiz BT tetkiklerinden ve sonuç olarak hayatlarının kalan kısmında klinikiyonizen radyasyon ile ilişkili oluşabilecek tümör benzeri etkilerden de koruyabiliriz.

Acil servise baş ağrısı şikayeti ile gelen her hastaya kraniyel ct gerçekten gerekli mi?

Aim: Headache is a common complaint in the emergency room (ER). Headache can be due to various etiologic factorsand it is important for an emergency physician to make a correct differential diagnosis. However, nowadays in Turkey,to obtain a cranial computed tomography (CT) has become almost a rule for each patient with complaints of headachein the ER. We aimed to fnd that each patient is really required cranial CT presenting with headache to the ER and topoint the importance of selection of patients while performing cranial CT also. Material and Methods: A retrospective review was undertaken in 1 year period. A total of 3567 CT s of patients wasassessed who were admitted to emergency Room (ER) in our hospital due to headache. The CT fndings were evalu- ated in terms of emergency pathologies. Results: Among 3567 patients with cranial CT, only 42 (1.17%) had emergency lesions. The rest of the patients hadno urgent pathology. Conclusion: In conclusion urgent cranial CT in patients presenting to the ER with headache may reveal signifcantfndings regarding the differential diagnosis and concomitant emergency pathologies. However, an effective and me- ticulous physical examination can exclude the need for CT in the majority of the patients. By this way, we can avoidthe patients from unnecessary CT s and as a result of; tumor like effects associated with clinical ionizing radiationdoses that can occur in the rest of their lives also.

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