title: Value of routine immediate postoperative brain computerized tomography in pediatric neurosurgical patients.
abstract: OBJECTIVE
  Routine immediate postoperative brain CT (RIPO CT) has advantages and disadvantages. The present study was performed to know the extent of gain by RIPO CT in the aspect of immediate postoperative patient care in pediatric patient population and according to the disease entity and surgical procedure.
  
  
  METHODS
  We reviewed 910 cases of pediatric brain surgery performed from January 2008 to March 2010 who had RIPO CT. The value of each examination was graded according to the impact of the CT findings on the decision making processes on postoperative patient care or on the understanding of postoperative patient's status: level I (urgent surgical procedures are necessary), level II (high level of attention should be paid because of possible urgent surgical procedure in near future), level III (RIPO CT is useful for understanding of postoperative change of patient's status), and level IV (no significant gain). The number of patients in each level was evaluated, and proportions of levels according to disease entity and surgical procedure were compared.
  
  
  RESULTS
  In total, the proportion of each level of I to IV was 0.4%, 4.9%, 3.5%, and 91.2%, respectively. The group of brain tumors, especially those who have malignant or highly vascular tumors, showed significantly higher value of RIPO CT. Cases of traumatic epidural hematoma and intracerebral hemorrhage revealed significantly high proportion of level II although no case underwent reoperation.
  
  
  CONCLUSIONS
  The results of present study may be useful for making policy of "selective" application of immediate postoperative brain CT according to the patient conditions. Also the use of immediate postoperative brain CT can be decided in individual cases by considering disease entity and surgical procedure.
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Jong-myung
authors.initials: JM
authors.lastname: Jung
authors.forename: Ji Yeoun
authors.initials: JY
authors.lastname: Lee
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Phi
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Kim
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Cheon
authors.forename: In-One
authors.initials: IO
authors.lastname: Kim
authors.forename: Kyu-Chang
authors.initials: KC
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging* / Q000601:surgery*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D011182:Postoperative Care / Q000379:methods / Q000592:standards; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*; D055815:Young Adult