Is routine computed tomography in strokes unnecessary? Costs outweigh benefits.

Until the results of early intervention trials are known, computed tomography should be used selectively rather than routinely in all patients with stroke. Scanning may be advised in young patients (under 65 years) or in those with an atypical course where there is diagnostic doubt and computed tomography would influence management. The cost and medicolegal implications of routine scanning are enormous and should be considered carefully in relation to other and possibly more effective strategies.