Clinical presentation and CT scan findings in patients of ischemic and hemorrhagic strokes

ABSTRACT

To compare the weighted clinical score and computed tomography scan brain of patients of ischemic and hemorrhagic strokes. This descriptive non-interventional study was conducted on 100 consecutive patients of all ages and both sexes presenting with stroke within 48 hours of the onset of the symptoms due to hemorrhage or infarction but not due to transient ischemic attack, reversible ischemic neurologic deficit, sub-arachnoid hemorrhage, tumors or trauma. The patients were admitted and examined, Siriraj Stroke Score was applied to make the clinical diagnosis and this score was compared with CT scan of the brain as gold standard. Out of 100 patients, eight were excluded due to invalid Siriraj Stroke Score between+1 to-1. Among 92 patients, 58.7% [54] were male and 41.3% [38] were female with a mean age of 61.8 +/- 7.8 years. Mean diastolic blood pressure was 94.78 mm Hg with range of 50 to 160. Hypertension was the most prevalent risk factor being present in 57.1% of ischemic and 54.4% of hemorrhagic patients. Clinically 72.8% [67] patients had ischemic and 27.2% [25] patients had hemorrhagic stroke. CT scan showed 76.1% [70] patients had ischemic and 23.9% [22] patients had hemorrhagic stroke. For ischemic strokes, Siriraj Stroke Score is 87%sensitive and 73% specific having a positive predictive value of 91%. For hemorrhagic stroke, Siriraj Stroke Score is 73% sensitive and 87% specific with a positive predictive value of 63%. Yule's coefficient using Chi-square test showed a high comparability between clinical and CT scan diagnoses. Siriraj Stroke Score needs to be further modified to be more objective and it should be compared with diffusion weighted magnetic resonance imaging as gold standard and not with computed tomography of the brain