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• SCAN SCORE VS SCAN
  Prahlad Sethi
  Published on: 16 July 2010

• Published on: 16 July 2010

  SCAN SCORE VS SCAN

  • Prahlad Sethi, Senior Consultant

  SCAN SCORE VS. SCAN-- WHICH IS JUSTIFIED

  PK Sethi*, A Batra**, L Khanna*** Department of Neurology, Sir Gangaram Hospital, New Delhi - 60, India

  While going through the article, The Scan Rule, published in JNNP of March 2010, Vol; 81 explaining the utility of scan score over conventional CT scans in diagnosing or ruling out small intra cerebral haemorrhages, we think that SCAN SCORES cannot score over con...

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  SCAN SCORE VS. SCAN-- WHICH IS JUSTIFIED

  PK Sethi*, A Batra**, L Khanna*** Department of Neurology, Sir Gangaram Hospital, New Delhi - 60, India

  While going through the article, The Scan Rule, published in JNNP of March 2010, Vol; 81 explaining the utility of scan score over conventional CT scans in diagnosing or ruling out small intra cerebral haemorrhages, we think that SCAN SCORES cannot score over conventional CT scans, given such reasons like the lack of CT scans and neuroinfrastructure facilities.

  It may be a useful method to rule out minor intra cerebral bleeds utilising this score at places where there are scarcity of CT scans, so that early antiplatelet therapy can be started to prevent early recurrent ischemic stroke.

  However, if we look at all aspects of the discussion, it can be said that it is unreasonable for a stroke patient to keep waiting for radiological confirmation for 7-10 days before an intracranial haemorrhage is diagnosed. It is worth noting that even in a developing country like India, there is no scarcity of CT scan centres. CT scans are available in all small diagnostic centres in the city. All this has been started as a private partnership in healthcare where the CT scan machines are installed at a huge cost. In India, CT scans are done at reasonable rates which include the cost of interpreting the scan and a waiting time of less than 12 hours. The cost of each CT scan is not more than $20. The scan centers earn their revenue not by high charges, but by increasing their numbers of patients and by working all days in the week. If we compare different parts of the country, we see that metropolitan cities like Delhi in India have nearly 90 CT scan centres and smaller cities like Meerut have 26 CT scans machines.

  So, instead of waiting for a CT scan and clinically ruling out an intracerebral haemorrhage by the SCAN rule it is advisable to start an entrepreneurship making available more number of CT scans to avoid the possibility of treating a small intra cerebral haemorrhage with apparently ZERO SCAN score with the antiplatelet agents. Also, one could probably avert the dangers of misdiagnosing intracerebral hemorrhage for infarction caused by the delays in scanning.

  *Senior Consultant Neurologist, **Consultant Neurologist, ***Senior Resident,. Department of Neurology, Sir Gangaram Hospital, New Delhi - 60, India

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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