Factors influencing the yield of cranial CT scanning in a private neurological practice.
A prospective study was performed to evaluate the yield of cranial CT scanning in 164 patients referred from a private neurological practice between 1986 and 1988. An over all rate of scan abnormality of 19% was noted. The most common presenting symptoms were headache (51) and seizure disorder (36) and the rates of scan abnormality in these disorders were 15% and 25%, respectively. The yield of CT scanning in patients with headache may be increased by taking age, sex and symptom duration into account, abnormalities being significantly more likely in males, those aged over 40 years and those with headache durations shorter than one month. Those with both symptoms and signs of a structural lesion were more likely to have abnormal scans than those with either symptoms alone or signs alone, both in the group as a whole and in the subgroup with headaches. The predictive value of symptoms suggestive of a structural lesion was influenced by age, sex and the presenting symptom. The yield was low in young females with headache and symptoms suggesting a structural lesion. Such symptoms had a higher predictive value for scan abnormality in patients with seizure disorder than in those with headache. Contrast administration demonstrated a low yield of lesions not seen on pre-contrast scans.
Reutens
D C
DC
Department of Neurology, Royal Perth Hospital, WA.
Stewart-Wynne
E G
EG
D000328:Adult; D000367:Age Factors; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*