Abstract
1. A 16 year review is made of the circumstances surrounding the admission of a patient with unsuspected cerebral tumor to an open psychiatric hospital.
2. The incidence of such patients represents 0.2% of admissions.
3. On retrospective analysis, organic mental changes were demonstrated in all cases and frequently were the earliest indication of disturbance. Awareness of the possible nature of these changes led to accurate diagnosis in some cases.
4. The incidence of psychotic or neurotic manifestations were frequent in the patient's pre-tumor history. This incidence was higher than would have been expected in a comparable group of patients admitted to a general or neurological hospital setting.
5. The misinterpretation of psychological mechanisms operating in response to the illness tended to confuse the diagnosis, particularly in the case of the slow growing tumors.
6. Neurological examination was the technique which often raised the suspicion as to the underlying pathology.
7. An integrated approach using previously outlined clinical and laboratory methods would appear to offer the best mode of detection at the present time.