Comparison of clinical diagnosis with computed tomography in ascertaining type of stroke.

BACKGROUND

Cerebrovascular Accident or stroke is a major cause of morbidity and mortality. For any treatment to be contemplated it is important to know whether we are dealing with a bleed or an infarct. This study was carried out to compare clinical diagnosis of stroke with Computed tomography (CT) scan findings in ascertaining the type of stroke (hemorrhagic or ischemic).

METHODS

This study was carried out at Department of Medicine, Ayub Teaching Hospital, Abbottabad from November 2001 to December 2003. One hundred consecutive patients fulfilling the inclusion criteria presenting with stroke were included. Clinical diagnosis was mainly based on presentation with specific emphasis on speed of onset, presence or absence of underlying cardiovascular diseases and past history of stroke. CT scan brain was carried out in all patients to confirm the diagnosis. The results were compared on case to case basis with CT diagnosis.

RESULTS

The patients included 71 males and 29 females, with an age range of 20-80 years. Clinically, 43% were suspected to have cerebral infarction, 25% intracerebral bleed and 32% indeterminate. CT scan brain showed 60% cerebral infarction, 27% intracerebral hemorrhages, 9% Space Occupying Lesion and 4% hemorrhagic infarct.

CONCLUSION

We found that clinical diagnosis in majority of the cases is not as reliable as the CT scan. It can help in diagnosis but cannot confirm it.