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CT Scanning and the Investigation of Dementia: A Review 1

Writing of pneumoencephalography (PEG) in the diagnosis of dementia, Critchley (1933) stated 'short-cuts to diagnosis are still treacherous'. These strictures are even more applicable to computed tomography (CT) because the short-cut is easier to negotiate and is without hazard to the patient. Thus while it is not surprising that the advent of CT created a climate of optimism with regard to its use in the diagnosis of dementia (Fox et 01. 1975, Menzer et 01. 1975), long-term follow-up studies ofpatients given this clinical label (Nott & Fleminger 1975, Ron et 01. 1979) suggest that caution needs to be exercised if a high proportion of incorrect diagnoses is to be avoided. The aim of this review is to evaluate critically the role of CT in patients showing cognitive impairment. Before addressing this issue a brief summary of some data from the PEG literature will be made, since it is against this background that the contribution of CT scanning must be assessed.