"Routine" brain CT in psychiatric patients - Does it make sense?

Purpose: To prospectively assess the spectrum of brain CT findings in psych iatric patients and to determine the number of patients that had an underly ing cause for the symptoms. Patients and methods: Over a period of six months, 142 patients (78 males, 64 females; median age 61 [18-91] years) were referred for CT brain scans. Their scans were reviewed, along with the clinical information that was pro vided in the request form. All the hard copies were reviewed to assess area s of ischaemia, infarction, atrophy, tumours, and haematomas. The majority of requests were to exclude vascular event or space-occupying lesions. Clin ical indications included mood disorders (depression, mania), schizophrenic disorders, dementia, personality and behavioural disorders. Results: 31 (22%) were normal. 111 (78%) had varying degrees of ischaemia, infarction and cerebral/cerebellar atrophy. 7 (4.9%) had space-occupying le sions which included two gliomas and five meningiomas. There were two chron ic subdural haematomas and one arteriovenous malformation. Conclusion: 1. ln our series, pathologic findings in "routine" brain CT's w ere encountered in 78%. 2. The incidence of brain tumours was 4.9%, compare d with 0.00005% of the general population. 3. CT scanning in psychiatric pa tients is cost-effective and especially indicated when there is an atypical presentation, or inadequate response to standard treatment.