Computed Tomography in the Elderly 3. Affective Disorder

1980 ◽  
Vol 136 (3) ◽  
pp. 270-275 ◽  
Author(s):  
Robin J. Jacoby ◽  
Raymond Levy

SummaryClinical and computed tomographic (CT) data on a consecutive series of 41 elderly patients with affective disorders are presented, and comparisons made with a group of 50 healthy controls. In both groups ventricular size increased with age, but only in the controls was there an age correlation with sulcal widening. Using clinical and radiological criteria, the prevalence of cerebrovascular disease in the patient group was 12 per cent. A sub-group of patients with enlarged ventricles emerged, whose first depression began later in life, and who at the time of this study were older and showed more ‘endogenous’ features than the remainder. It is suggested that this provides further evidence that organic cerebral factors may have aetiological significance in some depressions of old age.

1980 ◽  
Vol 136 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Robin J. Jacoby ◽  
Raymond Levy ◽  
John M. Dawson

SummaryComputed tomographic (CT) and brief psychometric findings on 50 psychiatrically and neurologically healthy community residents over 60 years old are presented. The need for normative CT data is emphasized, and the methodological problems in obtaining them are discussed. Measures of ventricular size were generally found to be greater than those reported by other workers, and variation with age was also found to be less marked than hitherto reported. A reciprocal relationship was found between a global rating of cortical atrophy and a test of memory and orientation. This communication forms the basis for comparison with groups of psychiatric patients to be presented in subsequent articles.


1980 ◽  
Vol 136 (3) ◽  
pp. 256-269 ◽  
Author(s):  
Robin J. Jacoby ◽  
Raymond Levy

SummaryClinical, psychometric and computed tomographic (CT) data are presented on three groups of elderly subjects: 50 normals, 40 patients with senile dementia and 41 suffering from affective disorder. Demented subjects showed significantly more CT evidence of cerebral atrophy than non-demented subjects, but there was considerable overlap. Although patients with a history or clinical signs of cerebral infarction were specifically excluded, such infarcts were found more often in CT scans of the dementia subjects than in the others, particularly when the diastolic blood pressure was raised. When correlating cognitive impairment with CT changes, ventricular size emerged as more important in the dementia patients, in contrast to the controls, in whom cortical atrophy was related to lower scores on a cognitive test. Other interesting findings included an inverse relationship between cortical atrophy and paranoid delusions.


2014 ◽  
Vol 23 (2) ◽  
pp. 338-346
Author(s):  
Laura Vargas Acauan ◽  
Maria Cristina Soares Rodrigues

Descriptive study, with qualitative approach, in order to understand the perception of the nursing staff regarding the safety of elderly patients in the administration of iodinated contrast media, conducted at the diagnostic imaging centers of two private hospitals, located in Brasília, Federal District, Brazil. Data were collected by technical interview of eleven participants, between July and August 2012. The analysis and processing of the data were made by means of the method of content analysis, bringing out the safety category of the elderly in the realization of cardiac computed tomography - coronarian angiography. The nursing staff understood that the safety of the elderly in the exam is associated with the ability to assess risks for adverse events related to the administration of the radiopharmaceutical, in which processes, technologies and human interactions intertwine, implying in safe practices.


Author(s):  
Daniel Pinggera ◽  
Marlies Bauer ◽  
Michael Unterhofer ◽  
Claudius Thomé ◽  
Claudia Unterhofer

AbstractSurgical treatment of acute subdural hematoma (aSDH) is still matter of debate, especially in the elderly. A retrospective study to compare two different surgical approaches, namely standard (SC, craniotomy size > 8 cm) and limited craniotomy (LC, craniotomy size < 8 cm), was conducted in elderly patients with traumatic aSDH to identify the role of craniotomy size in terms of clinical and radiological outcome. Sixty-four patients aged 75 or older with aSDH as sole lesion were retrospectively analyzed. Data were collected pre- and postoperatively including clinical and radiological criteria. The primary outcome parameter was 30-day mortality. Secondary outcome parameters were radiological. The mean age was 79.2 (± 3.1) years with no difference between groups and almost equal distribution of craniotomy size. Mortality rate was significantly higher in the SC group in comparison to the LC group (68.4% vs. 31.6%; p = 0.045). The preoperative HD (p = 0.08) and the MLS (p = 0.09) were significantly higher in the SC group, whereas postoperative radiological evaluation showed no significant difference in HD or MLS. A limited craniotomy is sufficient for adequate evacuation of an aSDH in the elderly achieving the same radiological and clinical outcome.


2018 ◽  
Vol 100 (4) ◽  
pp. 285-289 ◽  
Author(s):  
RW Radwan ◽  
AM Tang ◽  
WD Beasley

Background Increases in life expectancy has meant that a higher proportion of patients presenting to surgical assessment units are now elderly. Abdominal computed tomography (CT) can provide early and accurate diagnosis in the elderly, even in the presence of incomplete clinical and biological findings. The aim of this study was to investigate the use of early CT imaging in elderly patients presenting directly to the surgical assessment unit. Materials and methods All consecutive patients aged 65 years and over admitted directly to the surgical assessment unit between January 2017 and April 2017 were identified. Data were collected on demographics, laboratory investigations, radiological investigations and hospital admission. The primary outcome measure was overall length of stay. Results A total of 200 consecutive patients were identified and included over a six-month period. This comprised 110 women and 90 men with a median age of 78 years (range 64–98 years). A total of 83 patients underwent CT on admission to the surgical assessment unit. White cell count (WCC) and C-reactive protein (CRP) results were significantly higher in patients undergoing CT (P = 0.001). Median length of stay for patients undergoing CT was 5 days (range 1–19 days). This was significantly lower than those patients not receiving CT imaging, at 6 days (range 1–105 days; P = 0.034). Discussion CT should be considered as a first-line investigation when elderly patients with an acute abdomen are admitted to surgical assessment units. Early CT can accelerate hospital discharge and decrease overall length of hospital stay.


Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 714-721 ◽  
Author(s):  
Nestor R. Gonzalez ◽  
Joshua R. Dusick ◽  
Gary Duckwiler ◽  
Satoshi Tateshima ◽  
Reza Jahan ◽  
...  

Abstract BACKGROUND More elderly patients are presenting with intracranial aneurysms. Many are poor surgical candidates and often undergo endovascular treatment. OBJECTIVE We present our experience with embolization in elderly patients. METHODS We performed a retrospective review of a prospective database of elderly patients treated with coil embolization for intracranial aneurysms. RESULTS In a period of 16 years, 205 aneurysms were treated in 196 individuals (age range, 70–96 years; mean age, 77.3 years), including 159 females (average follow-up, 16.2 months). Ninety-seven patients presented with unruptured aneurysms, and 99 patients presented after subarachnoid hemorrhage; the diagnosis was confirmed by computed tomographic scan or lumbar puncture. Complete occlusion was achieved in 53 aneurysms (26%), with a neck remnant in 127 (62%), incomplete occlusion in 13 (6%), and 12 unsuccessful attempts. Postembolization, 89.3% of patients were neurologically intact or unchanged, whereas 8.7% had new deficits. Four patients died. By modified Rankin Scale score, at last clinical evaluation, 128 patients (65%) had a good outcome. Follow-up angiograms were available for 113 aneurysms; they revealed that 62% were unchanged, 21% were further thrombosed, and 17% had recanalized. Three aneurysms ruptured after treatment during follow-up. Rupture was not associated with incomplete occlusion or neck remnant results (P = .6). Twenty-five aneurysms required reembolization. Reembolization was not associated with new deficits or death (odds ratio, 0.56; 95% confidence interval, 0.19–1.58; P = .27). CONCLUSION Coil embolization of intracranial aneurysms is safe and effective in the elderly. Preembolization clinical condition strongly correlates with clinical outcome. Incomplete embolizations are not associated with a higher rerupture risk. Additional embolization does not affect the clinical results.


1986 ◽  
Vol 148 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Jonathan M. Bird ◽  
Raymond Levy ◽  
Robin J. Jacoby

The clinical, psychometric, and computed tomographic (CT) status of previously fit elderly volunteers is described at follow-up for up to four years. A number of relationships were found between psychometric and CT scores, but a dementing group could not be determined on the basis of a single scan. However, a subtle reduction in cognition over time was significantly related to CT changes, and occurred in 10%. Larger ventricles were also found in a small sub-group, who developed late-onset depressive disorders; recent bereavement was related to ventricular size. Thus a single CT scan may not be a useful discriminatory test in early dementia, but a repeat demonstrating ventricular enlargement, is likely to be significant. In the elderly, cognitive and CT scan deterioration should not be expected unless a disease process is occurring; this may be indicated by subtle cognitive impairment or by late-onset depressive disorder.


2006 ◽  
Vol 5 (1) ◽  
pp. 25-26
Author(s):  
R VIDALPEREZ ◽  
E ABUASSI ◽  
M PARAMODEVEGA ◽  
P VELOSO ◽  
A VARELAROMAN ◽  
...  

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