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Related Experiment Videos

Do surgical brain lesions present as isolated dementia? A population-based study

E M Alexander1, E H Wagner, D M Buchner

  • 1Department of Family Medicine, School of Medicine, University of Washington.

Journal of the American Geriatrics Society
|February 1, 1995
PubMed
Summary

Clinically significant subdural hematoma, hydrocephalus, and intracranial tumors are rare in older adults. A decision rule for computerized tomography (CT) in dementia showed high sensitivity, suggesting selective CT use may be feasible.

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Area of Science:

  • Geriatric Neurology
  • Neuroimaging
  • Epidemiology

Background:

  • Subdural hematoma (SDH), hydrocephalus, and intracranial tumors are potential causes of dementia.
  • Accurate diagnosis is crucial for appropriate management in elderly patients.
  • The utility of decision rules for neuroimaging in dementia requires evaluation.

Purpose of the Study:

  • To determine the incidence of clinically important SDH, hydrocephalus, and non-metastatic intracranial tumors in individuals aged 65 and older.
  • To assess the sensitivity of a proposed decision rule for guiding the use of computerized tomography (CT) in dementia patients.

Main Methods:

  • Population-based, retrospective case series design.
  • Inclusion of patients aged 65+ diagnosed with SDH, hydrocephalus, or intracranial tumors over a 4.5-year period.

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  • Evaluation of a decision rule based on 11 clinical criteria for CT indication in cognitive impairment.

    • Main Results:

    • Annual incidence rates per 100,000 were 46.7 for SDH, 5.8 for hydrocephalus, and 53.2 for intracranial tumors.
    • Increased risk of SDH observed with advancing age, with relative risks of 4.8 and 13.1 in older age strata.
    • Decision rule sensitivity for CT was 93.2% in patients with cognitive impairment and no trauma indicators.

    Conclusions:

    • These specific neurological lesions presenting as dementia are relatively rare in the elderly population.
    • The clinical presentation of these lesions often differs from typical Alzheimer's disease.
    • A decision rule may facilitate the selective and efficient use of CT scans in dementia evaluation.