ABSTRACT
Background: Cerebrovascular Accident or stroke is a major cause of morbidity and mortality all over the world, including Pakistan. Determination of type of stroke either hemorrhagic or infarct is important for start of any treatment. This study was carried out to compare clinical diagnosis of stroke with Computed tomography [CT] scan findings in ascertaining the type of stroke [hemorrhagicor infarct]
Methods: This study was carried out at Medical unit 3, Services Hospital, Lahore from July 2003 to December 2003 and December 2004 to April 2005. Sixty patients admitted to our ward for stroke lasting more than 24 hours, with at least unilateral motor weakness affecting face and/or arm and/or leg were included in the study. Clinical diagnoses of type of stroke i.e. hemorrhage or Infarct was made using a clinical parameter, with specific emphasis on speed of onset, presence or absence of vomiting, headache and altered state of consciousness. CT scan brain was used as a gold standard in all patients to confirm the diagnosis. The results were compared on case to case basis with CT diagnosis
Results: The study included 60 patients, 44 with ischemic stroke and 16 with hemorrhagic CVA Out of these 60 patients; clinical diagnosis correlated with CT findings in 46 patients [76.66%] whereas in 14 patients [23.33%], CT findings contradicted our clinical suspicion. Clinical accuracy was 84% [37/44] in case of ischemic stroke and 56% [9/16] in hemorrhagic stroke
Conclusion: The study has shown that although clinical evaluation of acute stroke can be made in most cases but CT scan is mandatory for excluding hemorrhage before start of treatment