TRADITIONAL methods of evaluating the neurologically impaired patient have undergone progressive modifications since the introduction of computerized tomography (CT) in 1972. In just five years, CT has become the single most valuable study for detecting and localizing intracranial disorders, frequently obviating further workup. Even if further evaluation is needed, the information gained by CT usually reduces the extent of further diagnostic study and permits the workup to be tailored to the specific problem. We report our approach to CT scanning after experience with 10,000 CT scans in 8,500 patients observed at Montefiore Hospital and Medical Center during the last two years.
Roentgenographic examination of the patient with suspected intracranial disease usually begins with plain skull roentgenograms. Tomography may be used subsequently in specific areas, eg, sella turcica and petrous pyramid. Thereafter, almost all patients whose conditions require further evaluation are studied by CT. Except in patients with clinical evidence of