Significance of cerebral CT in neurological practice

The significance of cerebral CT in neurological diagnostic practice was analysed in this prospective study on 1191 consecutive patients investigated during a one-year period. CT abnormalities were detected in 601 cases (51%), local hemispheral lesions (22%) generalized atrophy (19%) and infratentorial lesions (5%) being the most common findings. In the cases which had presented at referral to CT with clinical indices suggesting cerebral pathology the CT was abnormal in 71% (379 of 537) while the percentage was 34 (222 of 654) in the cases in which CT was performed for exclusion criteria. The clinical diagnostic reviewed by CT accuracy was 88% in cerebral tumours, 69% in cerebral infarction and from 83% to 94% in various intracranial hemorrhages but only 51% in cerebral atrophy which was the most common CT finding without clinical correlates. Apart from atrophy, CT revealed other pathology than clinically suggested in 147 cases (e.g. cerebral infarct in 58, hemorrhage in 16, tumour in 8 and diverse abnormalities in 54 cases). Contrast medium enhancement (used in 45% of the scans) provided more information when compared with the plain scan in 16% (86 of 537), no more than 3 lesions (0.6% of the enhanced scans; 2 meningeomas and one vascular malformation) being visible with enhancement only.