Computed tomography in the investigation of dementia

To assess the value of computed tomography in investigating patients with dementia, 500 consecutive patients presenting with a provisional clinical diagnosis of dementia of recent onset were reviewed and the results analysed in a computer. Most patients had either cerebral atrophy or infarction, but 82 patients had a normal scan and 42 others had tumours. More than 10% of all patients, including 5% with no other symptoms or signs, had a treatable lesion. Various associated symptoms and signs were useful pointers to such a treatable lesion and clearly indicated computed tomography. Accurate diagnosis is the cornerstone of proper management, and if a few patients with treatable lesions can be identified then the benefits to all concerned may be incalculable.