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Structural brain scanning in psychiatric patients: a further look
1Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston, USA.
The Journal of Clinical Psychiatry
|June 1, 1996
Summary
Refined brain scan guidelines for psychiatric patients show that new neurological signs and Alzheimer
Area of Science:
- Neuroimaging in Psychiatry
- Diagnostic Imaging
- Neurology
Background:
- Indications for brain computed tomographic (CT) and magnetic resonance (MR) scans in psychiatric patients lack clear definition.
- Previous surveys suggested indications, necessitating refinement through further study.
Purpose of the Study:
- To refine and update indications for ordering brain CT and MR scans in psychiatric patients.
- To correlate scan results with clinical information to improve diagnostic accuracy.
Main Methods:
- A survey of all brain scans ordered in a psychiatric teaching hospital over 23 months.
- Utilized a revised order sheet to gather information on the presumed need for scanning and relevant clinical factors.
- Correlated scan results with patient data.
Main Results:
- Out of 68 scans, 40 were normal, 16 equivocal, and 12 abnormal.
- Cognitive decline/confusion led to 30 scans, 7 abnormal (all Alzheimer dementia).
- Age over 40 was a significant factor in abnormal scan findings (10 of 12).
Conclusions:
- Confirmed the importance of new focal neurologic signs.
- Brain scans aid in diagnosing Alzheimer disease.
- New psychotic breaks or personality changes after age 50 warrant investigation.
- Cognitive decline in patients with prior psychosis is likely related to the psychosis itself.
- Isolated seizures or abnormal EEGs without other findings rarely indicate abnormal scans.
