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Computerized tomography and clinical correlation of stroke d | 16675
International Research Journals

Computerized tomography and clinical correlation of stroke diagnosis in University of Port Harcourt teaching hospital

Abstract

Onubiyi Chidiogo Chiedozie Brown, Nwankwo Nelson Chukwuemeka, Onwuchekwa Regina Chinwe, Ray-Offor Ogheneochuko Deborah, Eweputanna Lisa Ifeyinwa

The burden of stroke is high and is not only attributable to its high mortality but also its consequent high morbidity. Wrong clinical diagnosis has a high significance for patient outcome. Thus the need for accurate stroke diagnosis. Certainty of stroke diagnosis is markedly enhanced by computed tomography (CT) which has remained the most important brain imaging test fo r stroke in an emergency. This study was done to confirm clinical diagnosis of stroke using CT as seen in University of Port Harcourt Teaching Hospital (UPTH) and to determine the varying presenta tions and other findings which could mimic stroke clinically. This was a prospective study of 203 subjects with clinical diagnosis of stroke who had CT of the brain performed during a 12month period (November 2012 to November 2013). A 2-slice helical CT was used to obtain images in the axial plane. Images were classified as normal or abnormal scans. Abnormal scans were analyzed as ischaemic infarcts, intracerebral haemorrhage, subarachnoid haemorrhage (SAH), subdural haematoma, abscess, neoplasm, meningitis, and cerebral atrophy. The clinical diagnosis, age, sex and time of presentation of the patients were recorded. Statistical analysis was done with the Statistical Package for the Social Sciences (SPSS) software version 20. 0. Means were compared using Student's t test. Pearson's correlation coefficient was used to correlate CT findings with clinical diagnosis, age, and sex. P values < 0.05 were considered significant. The age distribution of the study population ranged from 6-90 years with a mean of 58.3+ 14.9years. Males were predominant at 51.7% of the sample size. The clinical diagnosis of stroke was confirmed in 74.9% of subjects while stroke mimics accounted for 13.3%, the rest (11.8%) were normal. This gave a misdiagnosis rate of 25.1%. Specific clinical di agnosis of stroke subtype (ischaemic or haemorrhagic) was correct in only 60% of cases. Despite a good rate of accurate clinical stroke diagnosis, a significant rate is misdiagnosed with potential for grave implication on patient morbidity. CT should be an essential aspect of stroke management.

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