The role of computed tomography brain scan in the diagnosis of acute stroke in the elderly.

In order to document the frequency with which nonvascular pathology may mimic stroke syndromes in the elderly, we prospectively studied 100 such admissions to a geriatric unit. Of 81 patients evaluated with computed tomography (CT) brain scan or autopsy only one patient with tumour (1.2%) was identified and this case is discussed fully. Nineteen patients did not have a CT scan or autopsy, though their presentation and clinical course was consistent with vascular pathology. This paper stresses the importance of documenting a comprehensive history and of regular clinical assessment of patients to identify atypical features which would alert the physician to consider nonvascular pathology. The incidence of nonvascular pathology presenting as stroke in the elderly is low. We conclude that CT brain scan is not indicated in the diagnosis of stroke in patients presenting to a geriatric unit.