• Handan Özen Olcay, Emine Emektar, Şeref Kerem Çorbacıoğlu, Zeynep Saral Öztürk, Sedat Akkan, and Yunsur Çevik.
• Ataturk Sanatoryum Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey. Electronic address: hozen84@hotmail.com.
• Am J Emerg Med. 2024 Jun 1; 80: 132137132-137.

Background/AimThe indications for neuroimaging in emergency department (ED) patients presenting with seizures have not been clearly defined. In this study, we aimed to investigate the findings that may influence the emergency management of patients with seizures undergoing brain computed tomography (CT) and the factors that influence these findings.Material And MethodsThis is a retrospective, single-center study. Patients presenting to the ED with seizures-both patients with diagnosed epilepsy and patients with first-time seizures-who underwent brain CT were included. Demographic information and indications for CT scans were recorded. According to the CT findings, patients were classified as having or not having significant pathology, and comparisons were made. Intracranial mass, intraparenchymal, subdural, and subarachnoid hemorrhage, fracture, and cerebral edema were considered significant pathologies.ResultsThis study included 404 patients. The most common reason for a CT scan was head trauma. A significant pathology was found on the CT scan in 5.4% of the patients. A regression analysis showed that hypertension, malignancy, and a prolonged postictal state were the predictive factors for significant pathology on CT.ConclusionCT scanning of patients presenting to the ED with seizures has a limited impact on emergency patient management. Clinical decision-making guidelines for emergency CT scanning of patients with seizures need to be reviewed and improved to identify zero/near-zero risk patients for whom imaging can be deferred.Copyright © 2024 Elsevier Inc. All rights reserved.

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