Akademik Veri Yönetim Sistemi
PEDIATRIC NEUROLOGY, cilt.2023, sa.21, ss.1-13, 2023 (SCI-Expanded)
Abstract Introduction: We aimed to evaluate the patients who underwent neuroimaging with the suspicion of neurosurgery pathology and identify the clinical warning signs for the early recognition of neurosurgical emergencies. Method: Patients aged 1 month to 18 years who underwent neuroimaging with the preliminary diagnosis of intracranial pathology requiring emergency surgery and symptom duration less than 1 month were included in the study. Patients were divided into three groups according to their definitive diagnosis as neurosurgical emergencies, neurological emergencies, and non-urgents. Results: A total of 140 patients were included in the study [The median age was 8 (IQR 3-13) years and 52.8% were male]. Neurosurgery emergency group and neurological emergency group were significantly younger than the non-urgent group (p<0.001). Vomiting, meningeal irritation findings and papilledema (grade 2 and above) were more common in the neurosurgical emergency group (p, 0.029, 0.023 and <0.001, respectively). For neurosurgical emergencies: In the presence of papilledema (grade 2 and above) and focal neurological deficit, the specificity was 99.2%, PPV 83.3%, NPV 88.1%, OR 36.8 (p<0.001, CI 4.04-336.0); in the presence of altered consciousness and focal neurological deficit, the specificity was 97.5%, PPV 50%, NPV 86.6%, OR 6.4 (p=0.014, CI 1.20-34.4) Conclusions: Neurosurgical and neurological emergencies may present with a variety of symptoms and their clinical presentations often overlap. Younger age, presence of vomiting, signs of meningeal irritation, grade 2 and above papilledema and altered consciousness are the crucial “warning signs" of a potential neurosurgical emergency.