Clinical evaluation of computed tomographic scanning.
Computed tomographic (CT) head scans were performed on 100 patients in a neurology ward. The CT scan was diagnostic in 67 patients and suggestive in a further three patients. Computed tomographic scans were most likely to be diagnostic in patients whose symptoms at presentation could be classified as "traumatic intracranial lesion", "space-occupying lesion", "acute cerebrovascular lesion", "dementia", and "epileptic disorder", and much less likely to be diagnostic if a patient presented differently. In all cases where the CT scan was diagnostic. It was considered that, had a CT scan not been available, alternative tests such as nuclear scan, cerebral angiography or pneumoencephalogram (PEG) would have been performed and would also have been diagnostic; no impact of the CT scan on diagnosis, therapy or patient outcomes was documented. However, in patients who received a CT scan, there was a 91% reduction in the PEGs, 85% reduction in cerebral angiograms, a reduction of 73% in nuclear scans and 31% in electroencephalograms. Computed tomographic scanning costs no more than the tests it replaces in the clinical setting studied, and offers significant advantages in patient comfort and safety.
D001927:Brain Diseases / Q000175:diagnosis*; D001930:Brain Injuries / Q000175:diagnosis; D001932:Brain Neoplasms / Q000175:diagnosis; D002561:Cerebrovascular Disorders / Q000175:diagnosis; D004827:Epilepsy / Q000175:diagnosis; D006801:Humans; D019965:Neurocognitive Disorders / Q000175:diagnosis; D014057:Tomography, X-Ray Computed