Abstract
Background: In the modern approach in treating patients with strokes requires early Computed Tomography (CT) scan as it is imperative to diagnose whether the stroke is ischemic or hemorrhagic. Clinical diagnosis of stroke does not always correlate with imaging; this is even worse when narrowed to clinical diagnosis of specific stroke subtype, creating a high potential for patient morbidity and mortality. Patients and methods: Prospective observational study was carried at stroke unit of Jimma University Medical Center from March 10-July 10, 2017. Result: Of the total 116 patients, 61 patients (52.6%) had CT scan of the brain performed, whereas the remaining (47.4 %) of patients were evaluated clinically alone to have stroke. Using World health organization (WHO) criteria, 51.7% patients had ischemic stroke while 48.3% had hemorrhagic, with Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH) accounting for 44.0% and 4.3%, respectively. The median time to perform CT scan after hospital arrival was 4 days. The most common site of lesion of brain of hemorrhage stroke patients was basal ganglia (48.4%) followed by parietal lobe (29.0%) and ventricular (29.0%). The most common site of brain infarct was parietal lobe (33.3%) and cortical (33.3%), followed by basal ganglia (23.3%) and caudate nucleus (20.0%). On CT scan majority of hemorrhagic and ischemic stroke patients had Intraparenchymal Bleed (IPB) only (61.3%) and right hemisphere involvement (26.7%) respectively. The predominant stroke etiology as Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria was undetermined etiology, 26 (43.3%), mainly because of incomplete evaluation. Conclusion: Etiologic investigation for stroke was infrequently performed by the lack of systematic cardiological examinations and brain imaging, most of the time for financial reasons and unavailability of the instruments. It is therefore, pertinent that CT scan/ MRI should be incorporated in stroke diagnosis and management where possible.
Highlights
The data from the Global Burden of Diseases (GBD) showed that the leading CVD cause of death and disability in 2010 in sub-Saharan Africa and other Low and Middle Income Countries (LMICs) was stroke [1-3]
The study was conducted at stroke unit of Jimma University Medical Center (JUMC), a tertiary hospital found in Jimma city, southwest Ethiopia, which is 352 kilometers from Addis Ababa
Etiologic investigation for stroke was infrequently performed by the lack of systematic cardiological examinations and brain imaging’s, most of the time for financial reasons and unavailability of the instruments
Summary
The data from the Global Burden of Diseases (GBD) showed that the leading CVD cause of death and disability in 2010 in sub-Saharan Africa and other Low and Middle Income Countries (LMICs) was stroke [1-3]. Stroke in young adults has a special significance in developing countries, as it affects the most economically productive group of the society [4] and even it is associated with higher mortality in this age group [5-7]. The proportion of Hemorrhagic Stroke (HS) is higher and greater case fatality in African and other LMICs than in high income countries [1,8,9]. This disparity is often described to racial or genetic factors, it may be due to differences in risk factor burden and associations across these population [8]. Clinical diagnosis of stroke does not always correlate with imaging; this is even worse when narrowed to clinical diagnosis of specific stroke subtype, creating a high potential for patient morbidity and mortality
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