Brain computed tomography in centenarians presenting to the emergency department: is age an indication to CT scan?

Abstract

This study aimed to explore the relationship between admission complaints and brain computed tomography (CT) examinations. Also, we evaluated the relationship between age and CT scan results in centenarians admitted to the emergency department for non-traumatic reasons. This study was a retrospective analysis of patients aged 100 years and older who presented to the tertiary hospital emergency department for non-traumatic reasons between 2012 and 2021. Demographic characteristics, admission complaints, and indications used for brain CT were evaluated. The Fazekas grade and Evans index were compared with a younger population aged 85-90 years. Brain CT was ordered in 41.1% (n: 15/34) of the patients due to their atypical symptoms. While no acute pathology was found in the CT scans, 23.5% of the patients had an incidental intracranial mass and/or chronic ischemic areas. When the leukoencephalopathy findings of the centenarian patients were compared to the patients aged 85-90, it was determined that the Fazekas grade increased with age (p = 0.002). Concerning the ventricle diameter, there was a significant difference between the two groups (p = 0.017), with larger values detected in the 85-90 years group. Although no acute pathology was found in the brain CT scans of the centenarian patients who presented to the emergency department for any reason other than trauma, CT plays a fundamental role in determining emergency diagnosis and management strategies in patients presenting with atypical symptoms. While the degree of leukoencephalopathy increased with age, the ventricle diameter was significantly larger in the younger age group than in the centenarian patients.