A CT-Based Study to Evaluate the Correlation Between Age-Related Cerebral Atrophy and Presenting Neurological Symptoms in Adult Patients: A Retrospective Cross-Sectional Analysis from Gujranwala, Pakistan

Age-related cerebral atrophy is one of the most prevalent radiological findings in ageing populations, yet its clinical significance particularly its correlation with specific neurological presenting symptoms—remains insufficiently characterised in South Asian contexts. This retrospective cross sectional study was conducted at THQ Hospital Wazirabad and Chattha Hospital, Gujranwala, Pakistan over a six month period, enrolling 66 adult patients (≥40 years) who underwent non contrast computed tomography (CT) of the brain. CT scans were evaluated for Evans’ index, ventricular enlargement (graded 1–3), cerebral atrophy severity (graded 1–3), early ischaemic changes, and the hyperdense vessel sign. Presenting neurological symptoms headache, seizures, slurred speech, ataxia, and numbness were extracted from medical records and correlated with imaging findings using chi square tests, Spearman’s rank correlation, and binary logistic regression in SPSS v31.0. The mean patient age was 52.1 ± 14.3 years (range 35–83) with a male predominance (72.7%). Moderate to severe atrophy was present in 50.0% of patients. Seizures (74.2%), slurred speech (63.6%), and ataxia (62.1%) were the most prevalent symptoms. Significant positive correlations were found between atrophy grade and age ( r = 0.72, p < 0.001), slurred speech ( r = 0.48, p < 0.001), ataxia ( r = 0.44, p < 0.001), and numbness ( r = 0.39, p = 0.001). Headache showed no significant correlation with atrophy severity ( p = 0.42). Logistic regression revealed that each one grade increase in atrophy severity raised the odds of motor/speech symptoms by 2.8 fold (95% CI: 1.6–4.9, p < 0.001), independent of age. These findings support the integration of standardised CT based atrophy reporting into routine radiology practice for older adults, especially in resource limited settings where MRI is not readily accessible.