Role of Computed Tomography in Evaluation of Cerebrovascular Accidents in a Tertiary Care Centre in Northern Kerala

ABSTRACT

Background: Cerebrovascular accident is one of the leading causes of death and disability throughout the world. It is the third most common cause of death after heart disease and cancer in India. Early diagnosis can improve the morbidity and mortality rates, as more advanced therapies are currently being instituted. Computed tomography imaging having wider availability, being cost effective and less time consuming, plays the role of first-line imaging modality. Many studies have been done all over the world to demonstrate the usefulness of computed tomography in management of cerebrovascular accident. Our study is aimed to establish the role of computed tomography in clinically suspected cases of cerebrovascular accident. The purpose of this study is to document the presence or absence of hemorrhage or infarcts, to find the location and reasonably assess the blood vessels involved and to spot the incidence of negative cases of clinically suspected stroke. Methods: A prospective study of 250 cases admitted to Academy of medical sciences, Pariyaram, Kannur with the clinical diagnosis of acute stroke were taken up for the study. Results: Out of 250 patients clinically suspected of CVA submitted for CT scan study of the brain. 150 patients i.e., 60% had infarcts. 70 patients i.e., 28% had haemorrhage,5 patients i.e., 2% had S.D.H.,5 patients i.e., 2% had C.V.T., 5 patients i.e., 2% had tumor and 15 patients i.e.,6% had normal scans. Infarcts formed the major group of the CVA cases i.e., 60%, involving most commonly the R.M.C.A. territory in patients i.e., 33.34%. Hemorrhage formed the second major group of the CVA cases i.e., 28.5%, involving most commonly the R.M.C.A. territory in patients i.e., 28.5%. Conclusions: The study showed that there is a preponderance of ischemic over hemorrhagic CVA. There is also a male preponderance in the occurrence of both hemorrhagic and ischemic CVA. C.T. Scanning is the “Gold Standard” technique for the diagnosis of acute stroke. And management of stroke depends upon “accurate diagnosis”. Hence, CT scan should be ideally done in all cases.