Tarolo G L, Zerbi D, Picozzi R, Sardella M, Zatta G
Radiol Med. 1981 Dec;67(12):971-5.
Six characteristic initial clinical neurological patterns were defined and their incidence was determined in one year caselist of patients hospitalized in the Neurology Department of the General Hospital of Saronno. Since the predictive value of a diagnostic procedure depends not only on sensitivity and specificity but also on the prevalence of disease in the population sampled, the prevalence of surgical brain lesions was evaluated retrospectively in this caselist for each of the clinical patterns previously defined, in order to evaluate the predictive value of serial brain scintigraphy and of brain computerized tomography. In this caselist the most frequent clinical patterns (stroke, skull trauma) show a low prevalence of surgical lesions, unlike it happens in the Neurosurgery Department of another hospital chosen as reference. It follows that in the sample of population constituted by the patients hospitalized for "stroke" in the Neurology Department of this hospital the Bayes' theorem yields a predictive value of brain scintigraphy not significantly inferior in respect of computerized brain tomography. In addition a review of the positive scans of patients with cerebral infarction has shown the possibility of a correct diagnosis in 95%. Therefore the serial scintigraphy is thought to keep a high value as a screening tool in this kind of patients where, after a simple clinical selection, the prevalence of brain lesions needing of surgery is low.
