Prospective evaluation of patients presenting to emergencydepartment with headache that undergo brain CT scan

KARALAR G., Prospective Evaluation of Patients Presenting to Emergency Department with Headache that Undergo Brain CT Scan, Hacettepe University Faculty of Medicine, Thesis of Emergency Medicine, Ankara, 2021. Patients presenting to emergency departments (ED) with headache constitute an important health problem. Nontraumatic headache patients make up 2% of all (ED) presentations and some studies suggest that this rate can be as high as %4. According to literature 14% of these patients undergo radiological imaging and 5.5% receive a pathological diagnosis. This study includes 386 patients that present to (ED) with nontraumatic headache who have Glasgow Coma Scale(GCS) of 15 and have no known intracranial pathology (tumor, arteriovenous malformation, history of intracranial hemorrhage, stroke, cranial surgery). Of the 58.3% patients were male(n=225) and 41.7% were female(n=161). Average age was 49.42(±15,803). Patients had a median systolic blood pressure of 150 mmHg, diastolic blood pressure of 87 mmHg, heart rate of 84 bpm, respiratory rate of 16 bpm, and pain scale of 8. Of the 21.5% patients also had nausea and 12.7% had vomiting. Of those 39.8% had nausea also had vomiting. Of the %13.3 patients with nausea had been using anticoagulant medications. These rates were statistically significant when compared with the other complaints of the patients and the other drugs they had been using. (p<0.05) Brain CT scans revealed no pathology in 74.1%, non-emergent pathology in 17.4%, urgent pathology in 3.1%, and emergent pathology in 5.4%. Our study revealed that some patients with additional complaints of nausea, vomiting and dizziness received serious diagnoses that require emergent intervention or hospitalization after CT scan. Patients presenting to ED with complaints of headache and accompanying nausea or vomiting should be evaluated carefully even though they may have normal neurological examination, GCS score of 15 and fail SNNOOP10 criteria. Therefore, clinicians should consider imaging studies in such patients.