| Popis: |
Background: In developing countries like Uganda, the burden of stroke is growing and causing significant morbidity and disability with high mortality rates. Neuroimaging is required to differentiate ischemic stroke from an intracerebral hemorrhage, as well as to diagnose entities other than stroke. Therefore, understanding the clinico-demographic features and brain Computed Tomography (CT) findings of stroke as well as their correlation is of utmost value in stroke management. Hence, this study sought to determine the clinical and brain CT scan findings of stroke patients attending selected centers in Kampala. Mention ASPECTS briefly Methods: This was a cross-sectional study of clinically suspected stroke patients at three selected hospitals in Kampala, Uganda. All brain CT scans of patients with suspected stroke were evaluated and The Alberta stroke programme early CT score (ASPECTS) a 10-point quantitative topographic CT scan score used for middle cerebral artery (MCA) stroke patients. Data on the clinical-demographic and cranial CT findings were collected, and entered into REDCap software. Univariate analysis was used to describe the clinico-demographic and cranial CT features of stroke and summarized them as percentages. Further analysis was done at bivariate and multivariate levels to determine the adjusted odds ratios as a measure of association with a 95% confidence interval. Results: Of the 270 study participants,141(52.2%) were male. 162(60%) had CT findings of stroke, and 90(33.3%) had normal cranial CT findings. While 18(6.7%) had other CT findings like a tumor, dural hemorrhage, epidermoid cyst, and others. The ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage accounted for 124(45.9%), 34(12.6%), and 4(1.5%) respectively. Limb weakness (55.2%), headache (41.1%), and loss of consciousness (39.3%) were associated with stroke findings on CT. Among the acute ischemic strokes, 30(73.2%) had a worse (0-7) ASPECT score. Those aged ≥65 years were associated with a worse ASPECTS [AOR: 22.01, (95%CI:1.58-306.09) p-value =0.021]. Conclusion: Currently, non-contrasted brain CT is the first line imaging modality for diagnosis, differentiation of the stroke types, patient management, treatment, and timely referral to a stroke center. The clinical diagnosis of stroke is inadequate to exclude other stroke mimics. Hypertension and advanced age are the most prevailing risk factors attributed to both ischemic and hemorrhagic stroke and patients over 65 years were associated with a worse ASPECT score. |
