CRANIAL COMPUTED-TOMOGRAPHY OF ELDERLY PATIENTS - AN EVALUATION OF ITS USE IN ACUTE NEUROLOGICAL PRESENTATIONS

We assessed the use of cranial computed tomography (CT) in elderly pat ients with acute neurological deficit and its influence on patient man agement. Clinical notes from 100 consecutive CT referrals from geriatr ic admissions presenting with acute neurological deficit were reviewed and categorized according to clinical presentation. CT results and su bsequent therapy were recorded. Twenty of the patients had treatable l esions (in 6 out of 14 patients with signs atypical of stroke and 7 ou t of 19 patients with acute confusion). These two groups contained 68% of all treatable lesions found. Forty-four scans yielded no new diagn ostic information; these included all scans for transient ischaemic at tacks and for progression of stroke. The remaining scans yielded infor mation regarding pathology but did not alter patient management. CT is a valuable first-line investigation in elderly patients presenting wi th signs atypical of stroke and unexplained confusion but may be less useful in patients with other presentations.