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© 1990 Oxford University Press

research-article

The Contribution of Computerized Tomography to the Differentia Diagnosis of Confusion in Elderly Patients

MARGARET A. ROBERTS and F. I. CAIRD

Department of Geriatric Medicine, Victoria Infirmary Glasgow G41 3DX
University Department of Geriatric Medicine, Southern General Hospital Glasgow G51 4TF

Two hundred and eighty elderly patients who were referred because of a principal problem of confusion were investigated by computerized tomography; 94°o were suffering from a ‘dementia syndrome’ and unrecognized receptive dysphasia was the commonest problem in the remainder. One.hundred and twenty-four patients were suffering from senile dementia of the Alzheimer type, and 79 from multi-infarct dementia. Space-occupying lesions (tumour, subdural haematoma or hygroma) were found in 32 (11 %). Of the 25 with other intracranial and extracranial causes, 64°o had potentially treatable lesions (PTL). In only four cases was no diagnosis made.

PTL were found in 31 % of 170 patients with a duration of confusion of less than a year compared with 1 % of 110 patients with a longer duration. In 48 of the former group, confusion was an isolated phenomenon; 12 of these (25%) had a PTL, as had 27 of 88 with confusion and a focal neurological deficit (31%). All five patients with recognized seizures, and six of 15 of those with reduced alertness had PTL. Twenty of 37 patients with neurosurgical lesions underwent surgery.

Revision received March 23, 1989.
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