Psychiatric Bulletin (2005) 29: 193. doi: 10.1192/pb.29.5.193-a
© 2005 The Royal College of Psychiatrists
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Psychiatric Bulletin (2005) 29: 193
© 2005 The Royal College of Psychiatrists

Correspondence

Cranial computed tomographic scans in elderly people - often do they influence clinical management?

Anne M. Aboaja, Senior House Officer in Psychiatry

Nottingham Psychotherapy Unit, 114 Thorneywood Mount, Mapperley, Nottingham NG3 2PZ

Fielding’s study ‘The value of cranial computed tomography in old age psychiatry: a review of the results of 178 consecutive scans’ (Psychiatric Bulletin, January 2005, 29, 21–23) assessed the value of cranial computed tomographic (CT) scans in the elderly population and evaluated the recommendations of the Royal College of Psychiatrists on the selection of patients for scanning. However, the article was erroneous in stating that the College recommends all patients to be scanned unless the ‘history is typical OR history greater than 1 year’. The College in fact recommends that all patients receive a scan ‘unless the patient has a history of more than a year AND there is a typical clinical picture’ (Royal College of Psychiatrists, 1995).

The author concluded that the study added validity to the College’s criteria and suggested that cranial CT scans might influence patient management. I conducted an audit review of 56 cranial CT scans in elderly people. In 51%, clinical management was not influenced by the CT scan. This group included those who were unwilling to receive treatment. Fielding stated that the prevalence of truly reversible causes of dementia identified by cranial CT is extremely low. In support of this, in my audit review none of the scan results showed evidence of potentially reversible causes of dementia.

References

  1. FIELDING, S. (2005) The value of cranial computed tomography in old age psychiatry: a review of the results of 178 consecutive scans. Psychiatric Bulletin, 29, 21 –23.[Abstract/Free Full Text]
  2. ROYAL COLLEGE OF PSYCHIATRISTS (1995) Consensus Statement on the Assessment of an Elderly Person with Suspected Cognitive Impairment by a Specialist Old Age Psychiatry Service (Council Report CR49). London: Royal College of Psychiatrists.




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