Acute stroke in Jos University Teaching Hospital: Cranial computed tomographic findings and accuracy of the clinical diagnosis

Abstract

Background: Cranial computed tomography (CT) is an invaluable tool useful in promptly differentiating hemorrhagic from ischemic stroke. However, due to the cost of CT, there has been a reliance on the World Health Organization (WHO) clinical diagnosis of stroke in some low-resource settings. Objective: The aim of the present study is to determine the pattern of acute stroke as seen on CT and to determine the accuracy of the clinical diagnosis using the WHO method. Materials and Methods: This was a cross-sectional descriptive study conducted from September 2014 to June 2015. We included 150 consecutive patients aged 18 years and above with acute stroke. Initial physician diagnosis using the WHO method was obtained, followed by a radiological evaluation using CT. The Statistical Package for the Social Sciences version 20.0 with results represented in simple proportions and percentages. Statistical level of significance was set at P ≤ 0.05. Results: The mean age (standard deviation) was 57.97 (14.2) years with females making up 50.7% (76/150). Ischemic stroke was found to be the more common type of acute stroke (69.3%) (104/150) with the parietal lobe being the site most commonly affected by both strokes types. The positive predictive and negative predictive values of the WHO clinical diagnosis for ischemic and hemorrhagic strokes were 79.13% and 68.97% and 68.97% and 79.13%, respectively. Conclusions: A low accuracy in the WHO clinical diagnosis of stroke was observed. Ischemic stroke is the more common stroke and parietal lobe the most commonly affected site.

Keywords

• Computed tomography
• Nigeria
• parietal lobe
• stroke