A review of the first CT scans of the head in patients referred from Kenyatta National Hospital

Abstract

A total of 109 patients with CT scans of the head from Kenyatta National Hospital were reviewed. Twenty eight per cent of the patients were children under 10 years of age; the majority of whom hac a CT diagnosis of primary brain tumour. Primary brain tumours were the commonest intracranial lesions observed and accounted for 87%. The next common intracranial lesion was haemorrhage following trauma. Hydrocephalus was found in 19% of patients (70% were secondary to obstructing masses, 10% due to brain atrophy, 10% due to aqueductal stenosis and in 10% no demonstrable cause was shown). 90% of patients had a provisional diagnosis of space occupying lesion and headache was the most frequent presenting symptom (58%). The accuracy CT scanning as a screenlng technique was found to bs 100% (there were no false negatives although the follow-up period was short). By comparison, the diagnostic accuracy for plain skull radiography was found to be 49%, air encephalography /ventriculography 83% and angiography 69%. The diagnostic accuracy of CT for specific lesions e.g., traumatic haemorrhages, hydrocephalus, CSF cysts was found to be high and less for other lesions e.g., abscesses, tumours. A large number of patients were operated upon without invasive contrast studies e.g., angiography (66%). Hospital stay after CT was done and before definitive treatment commenced was found to be shorter (2verage 17.6 days) than hospital stay before CT was done (average 27.5 days).