DIAGNOSTIC YIELD IN COMPUTED TOMOGRAPHY OF THE BRAIN IN CLINICAL ABSENCE OF NEUROLOGICAL DEFICIT PATIENTS

Abstract

Objective:
1. to assess diagnostic yield in computed tomography of the brain in variable complaints and clinical absence of neurological deficit patients.
2. to determine correlation between age, sex , underlying disease and the abnormal computed tomographic finding.

Materials and methods: During July 2005-September 2006, 115 patients with variable complaints but clinical absence neurological deficit were examined by general medicine, neurologist and neurosurgeon (53 women, 62 men, mean age 53.03, range 11-95 years) at the general medicine department. The clinical records were reviewed for clinical information.
Three observers assessed the plain and contrast study of the computed tomography of the brain for abnormal findings. The outcomes described as negative finding, minor positive findings (abnormal finding without changed of treatment) and major positive findings (abnormal finding with changed of treatment).

Results: The positive study (major and minor positive) in the computed tomography of the brain in clinically no neurodeficit patients is 59.1%. There was 35.7% with major positive, or distinctive abnormal findings with altering of the management.
The ages and underlying diseases have strong correlation with abnormal CT findings but there is no correlation with sex.

Conclusion: Diagnostic yield in hospital-based patients with variable complaints but without clinically neurological deficit was about 60% but enough for decision of treatments, the yield remained only 35.7%. In advanced ages and underlying disease patients had the evidence base for more opportunity in having abnormal computed tomography but no difference between sex. The strictly following guideline for each complaint will help in increasing the yield.