COMPUTED TOMOGRAPHIC PATTERN OF STROKE IN ADULT PATIENTS AT FEDERAL TEACHING HOSPITAL GOMBE, NORTH-EASTERN NIGERIA
Background: Stroke and its complications are major health problems in developing countries including Nigeria. It could be a major cause of death or disability especially when only clinical assessment is relied upon for diagnosis. Cranial computed tomography (CT) is a valuable tool for the diagnosis of stroke. CT pattern of stroke in the North Eastern Nigeria has not been fully described. Materials and Methods:This was a prospective descriptive study conducted at the Federal Teaching Hospital, Gombe from June 2016 to December 2016. One hundred and thirty patients who presented with clinical features of stroke and were referred to Radiology department for cranial CT were consecutively selected. A total of 111 had CT scan features of acute stroke, 6 had brain atrophy, 8 had intracranial space occupying lesions and 5 were normal brain CT. Hence 111 patients with CT features of stroke were analysed using SPSS version 16.0 package. A p-value of ≤ 0.05 and a confidence interval of 95% was adapted for statistical analysis.The variables were expressed as range and mean plus standard deviation. All comparison of variables were done applying kappa statistic and point-biseral correlation coefficient for the correlation analysis.Results: There were 69 (62.2%) males and 42 (37.8%) females aged 18-30 years (mean ± SD of 57.49 ± 13.47 years). Ninety four patients (84.7%) had ischaemic stroke, while the remaining 17 (15.3%) had haemorrhagic stroke. Lobar location was identified as the most common site of ischaemic stroke while thalamo-ganglionic area was the commonest location for haemorrhagic stroke. This study found a discordance between clinical and CT diagnosis of stroke kappa = 0.289. Age and hypertension were found to be the commonest risk factors associated with both ischaemic and haemorrhagic stroke. Conclusion It is evident from this study that clinical diagnosis of stroke subtypes may not be reliable without neuroimaging, further justifying the need for CT scan in the proper evaluation of stroke patients. The middle cerebral artery territory was the commonest vascular territory involved in stroke while
hypertension and age are common risk factors for both ischaemic and haemorrhagic stroke.