Anatomical features of the brain of patients with stroke (cerebrovascular accident) relative to types, sites, and shapes using computed tomography scan

Abstract

Objectives: Stroke is becoming a very common disease, giving rise to an increased morbidity and mortality globally; yet, its diagnosis is shrouded in the phrase “cerebrovascular accident.” The objectives of the study were to evaluate the various types, sites, and shapes of stroke presentation using computed tomography (CT) scan. Material and Methods: A total of 500 subjects indicative of stroke referred for cranial CT scans were recruited at the Jos University Teaching Hospital, Jos and the Asi-Ukpo Hospital, Calabar. With ethical approval, a proportionate random probability sampling method was used to obtain archived cranial CT images of the different types, sites, and shapes of the lesions, viewed directly from the CT scanners. Data obtained were analyzed using Statistical Package for the Social Science and results expressed as percentages and frequencies at P < 0.05. Results: The highest occurring type of stroke was ischemic (63.2%). Others were hemorrhagic (22.8%), cerebral atrophy (4.2%), cerebral infarct with atrophy (1.6%), intracerebral (0.8%), subarachnoid (1.4%), and subdural hemorrhage (0.8%). The left parietal lobe (24.8%) was the most common site of stroke occurrence while the left occipital, left temperoccipital, and left temperoparietal lobes had 7.6%, 7.4%, and 5.6%, respectively. Furthermore, 30.8% of cases presented as either oval hyperdense or hypodense lesions. Irregular lesions were 21.8% of cases while triangular, circular, and rectangular lesions occurred in 11.6%, 8.4%, and 6.4% of cases, respectively. Meanwhile, 8.0% of cases had normal CT brain scan that presented as stroke mimics on pattern recognition. Conclusion: The study revealed a distorted gross anatomy of the brain with preponderance of left-sided intracerebral ischemic stroke mostly in the left parietal lobe that presented as oval hyperdense and hypodense lesions in the sampled Nigerian population.