Objective: To evaluate the reasons for central nervous system imaging in the pediatric emergency department for any cause except trauma, and the significance of red flag findings and imaging results.

Material and Methods: Children presenting to the pediatric emergency department for non-traumatic causes in a one year period and undergoing central nervous system imaging were examined retrospectively. Demographic and clinical characteristics, and imaging results were evaluated. Clinical characteristics and red flag findings were classified in terms of the significance of imaging results.

Results: The most common reasons for central nervous system imaging in the pediatric emergency department of the 513 children analyzed were seizure, followed by altered consciousness, headache, and ventriculoperitoneal shunt malfunction. Transfontanelle ultrasound was performed on 109 children (21.2%), while brain computerized tomography (CT) was applied on 182 (35.4%), cranial magnetic resonance imaging (MRI) on 279 (54.3%), spinal MRI on 22 (4.4%), and cerebro arterial magnetic resonance angiography on seven (1.3%). Abnormal findings were observed in any of the imaging technique in by 73 patients. No statistical significance was determined between CT and cranial MRI through these findings (McNemar test, P=0.05). No significant finding in imaging was observed in 56% of children. Clinically significant findings were determined at imaging in all children (73) with red flag findings.

Conclusion: Seizure was the principal cause of presentation in children undergoing central nervous system imaging. Significant findings were determined in all patients with red flag findings undergoing central system imaging in the emergency department for reasons other than for trauma. All children with a neurological disorder must be evaluated in terms of these findings.