O poder de interpretação na análise de tomografias de crânio (TCC) entre neurocirurgiões e radiologistas tem sido pouco estudada. O objetivo deste estudo é avaliar as taxas de concordância na interpretação de TCCs entre neurocirugiões e radiologista em um departamento de emergência. Método 227 TCCs foram independentemente analizadas por 2 neurocirugiões (NC1 e NC2) e um radiologista(RAD). O índice de concordância nas análises foi estudada posteriormente. Resultados O valor de Kappa obtido entre os NC1 e NC 2 e entre estes e RAD foram quase perfeitos e substancial respectivamente. O maiores índices de concordância quando avaliadas anormalidades foram observados na identificação de tumores, hidrocefalia e hematomas intracranianos. O piores índices foram observados com relação a leucaraiose e redução volumétrica. Conclusão Para doenças apresentadas em um departamento emergência que demandam tratamento mais agressivo o índice de concordância na interpretação de TCCs entre RAD e NC foi satisfatório.

The power of interpretation in the analysis of cranial computed tomography (CCT) among neurosurgeons and radiologists has rarely been studied. This study aimed to assess the rate of agreement in the interpretation of CCTs between neurosurgeons and a radiologist in an emergency department. Method 227 CCT were independently analyzed by two neurosurgeons (NS1 and NS2) and a radiologist (RAD). The level of agreement in interpreting the examination was studied. Results The Kappa values obtained between NS1 and NS2 and RAD were considered nearly perfect and substantial agreement. The highest levels of agreement when evaluating abnormalities were observed in the identification of tumors, hydrocephalus and intracranial hematomas. The worst levels of agreement were observed for leukoaraiosis and reduced brain volume. Conclusions For diseases in which the emergency room procedure must be determined, agreement in the interpretation of CCTs between the radiologist and neurosurgeons was satisfactory.

OBJECTIVE: Aneurysmal subarachnoid hemorrhage puts patients at high risk for the development of pituitary insufficiency. We evaluated the incidence of pituitary dysfunction in these patients and its correlation with clinical outcome. METHODS: Pituitary function was tested in 66 consecutive patients in the first 15 days after aneurysmal subarachnoid hemorrhage. The following were measured in all patients: thyroid-stimulating hormone, free thyroxine, triiodothyronine, luteinizing hormone, follicle-stimulating hormone, total testosterone (in males), estradiol (in females), prolactin, serum cortisol, plasma adrenocorticotropic hormone, growth hormone and insulin growth factor. RESULTS: The endocrine assessment was made at a mean of 7.4 days (standard deviation ±6.6) after subarachnoid hemorrhage. Forty-four (66.7%) female and 22 (33.3%) male patients were evaluated. Thirty-nine patients (59.1%) had some type of pituitary dysfunction. Follicle-stimulating hormone/luteinizing hormone deficiency was the most frequent disorder (34.8%), followed by growth hormone/insulin growth factor (28.7%), adrenocorticotropic hormone (18.1%) and thyroid-stimulating hormone (9%). Seventeen (25.7%) patients showed deficiencies in more than one axis. A greater incidence of hormone deficiency was observed in patients with a Glasgow Coma Scale score ≤13 (t test, p = 0.008), Hunt-Hess grade ≥4 (t test, p<0.001), or Fisher grade 4 (t test, p = 0.039). Hormone deficiency was not significantly associated (p>0.05) with increased hospitalization or clinical outcome. CONCLUSION: Pituitary dysfunction was identified in a substantial portion of patients with previous aneurysmal subarachnoid hemorrhage, but no association was found between this dysfunction and poor clinical outcome.

OBJETIVO: Verificar a freqüência de trauma craniencefálico (TCE) nos indivíduos entre 0 e 19 anos, de acordo com o gênero, idade e etiologia. MÉTODO: Estudo descritivo realizado por meio da pesquisa em prontuário e relato das vítimas de trauma craniencefálico com idade até 19 anos, admitidas em hospital de referência para o atendimento a politraumatizados no Estado da Bahia, por um período de 1 ano. RESULTADOS: Amostra constituída de 390 pacientes, dentre os quais 280 (71,8%) eram do sexo masculino. A faixa etária mais acometida foi a de adolescentes (10 a 19 anos) com 177 pacientes (45,4%). A causa mais comum foi a queda de altura (34,4%). Segundo a pontuação na Escala de Coma de Glasgow, 89% dos pacientes sofreram TCE leve. CONCLUSÃO: O grupo de adolescentes foi o mais atingido, sendo a queda de altura a principal causa de TCE, com predomínio do gênero masculino, havendo preponderância do trauma leve.

OBJECTIVE: To verify the frequency of traumatic brain injury (TBI) in the people between 0 and 19 years of age, in accordance to gender, age and cause of trauma. METHOD: Descriptive study made through a period of a year, in all TBI victims, aged until 19 years admitted in a reference trauma center. RESULTS: The sample had a total of 390 patients; 280 (71.8%) were boys. The main age of the victims was between 10 to 19 years (adolescents) with 177 patients (45.4%). The most common cause of trauma was height falls (34.4%). According to the Glasgow Coma Scale, 89% had suffered mild TBI. CONCLUSION: The main group of victims was the adolescents; the most important cause of TBI was height fall, with masculine predominance and mild trauma.