title: Incidental findings on cranial imaging in nonagenarians.
abstract: OBJECTIVE
  The aim of this article was to report on the nature and prevalence of incidental imaging findings in a consecutive series of patients older than 90 years of age who underwent intracranial imaging for any reason.
  
  
  METHODS
  The authors retrospectively reviewed the electronic medical and imaging records of consecutive patients who underwent brain MR imaging at a single institution over a 153-month interval and were at least 90 but less than 100 years of age at the time of the imaging study. The prevalence of lesions by type in this consecutive series of MR imaging evaluations was calculated for all patients. The authors reviewed the medical record to evaluate whether a change in management was recommended based on MR imaging findings. They evaluated patient age at the time of death and the time interval between MR imaging and death.
  
  
  RESULTS
  The authors identified 177 patients who met the study criteria. The group included 119 women (67%) and 58 (33%) men. Their mean age was 92.3 ± 1.8 years. Evidence of acute ischemic changes or cerebrovascular accident (CVA) was found in 36 patients (20%). Fifteen patients (8%) had an intracranial tumor. Intracranial aneurysms were incidentally identified in 6 patients (3%). Chronic subdural hematomas were found in 3 patients (2%). Overall, 25 patients (14%) had some change in medical management as a result of the MR imaging findings. The most common MR imaging finding that resulted in a change in medical management was an acute CVA (p < 0.0001). The mean time to death from date of MR imaging was 2.5 ± 2.3 years.
  
  
  CONCLUSIONS
  Intracranial imaging is rarely performed in patients older than 90 years. In cases of suspected stroke, MR imaging findings may influence treatment decisions. Brain MR imaging studies ordered for other indications in this age group rarely influence treatment decisions. Incidentally discovered lesions in this age group are generally not treated.
authors: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48109-5338, USA.
authors: Wajd N
authors: WN
authors: Al-Holou
authors: Adam
authors: A
authors: Khan
authors: Thomas J
authors: TJ
authors: Wilson
authors: William R
authors: WR
authors: Stetler
authors: Gaurang V
authors: GV
authors: Shah
authors: Cormac O
authors: CO
authors: Maher
mesh_terms: D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D046648:Hematoma, Subdural, Intracranial / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D033162:Incidental Findings; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D012189:Retrospective Studies