Brain Computed Tomography evaluation of patients with syncopal episode in the emergency department at King Hussein Medical Center

Abstract

Objective: The aim of our study is to determine the value of using brain computerized tomography  as a routine investigation in patients presenting with syncope to the emergency department at King Hussein Medical Center Amman Jordon.
Methods: In the time period between March 2006 and April 2008, a total of 254 patients (134 males and 120 females) with a mean age ± SD of 62 ±27 years (range: 32-73) presented with syncope to the emergency department. All of these patients underwent various investigations to
verify the cause of syncope including brain CT scan. Patients were categorized into three groups according to CT scan findings and their neurological examination on presentation.
Results: Patients were classified into three groups based on their brain CT findings and their neurological examination on presentation.
The first group included 203 (79.9 %) patients, all of which had normal brain CT scan and normal neurological examination. The second group included 10 (3.9%) patients all of which had abnormal brain CT scan findings and abnormal neurological examination. The abnormal neurological findings can be attributed to their syncopal episode and abnormal brain CT findings. The third group included 41 (16.1%) patients who had abnormal brain CT findings and either normal or abnormal neurological examination which is not related and can’t be attributed to the
abnormal head CT findings and their syncopal episode.
Conclusion: The use of brain CT scan as a routine investigation in the evaluation of patients presented to the Emergency Department at king Hussein Medical Center with syncope is unjustifiable, unless these patients had abnormal neurological examination.

Keywords: Syncope, Brain CT scan, Emergency Department, Transient loss of consciousness.