Computed tomography patterns of intracranial infarcts in a Ghanaian tertiary facility.

Objective: To determine the Computed Tomography (CT) patterns of intracranial infarcts. Design: A retrospective cross-sectional study. Setting: The CT scan unit of the Radiology Department, Cape Coast Teaching Hospital (CCTH), from February 2017 to February 2021. Participants: One thousand, one hundred and twenty-five patients with non-contrast head CT scan diagnosis of ischaemic strokes, consecutively selected over the study period without any exclusions. Main outcome measures: Patterns of non-contrast head CT scan of ischaemic strokes. Results: About 50.6% of the study participants were females with an average age of 62.59±13.91 years. Males were affected with ischaemic strokes earlier than females (p<0.001). The risk factors considered were, hyperlipidaemia (59.5%), hypertension (49.0%), Type 2 diabetes mellitus (DM-2) (39.6%) and smoking (3.0%). The three commonest ischaemic stroke CT scan features were wedge-shaped hypodensity extending to the edge of the brain (62.8%), sulcal flattening/effacement (57.6%) and loss of grey-white matter differentiation (51.0%), which were all significantly associated with hypertension. Small deep brain hypodensities, the rarest feature (2.2%), had no significant association with any of the risk factors considered in the study. Conclusion: Apart from the loss of grey-white matter differentiation, there was no significant association between the other CT scan features and sex. Generally, most of the risk factors and the CT scan features were significantly associated with increasing age. Funding: None declared.

Postmortem diagnosis of COVID-19: Antemortem challenges of three cases at the 37 Military Hospital, Accra, Ghana.

BACKGROUND: Consistency among clinical symptoms, laboratory results and autopsy findings can be a quality measure in the diagnosis of coronavirus disease 2019 (COVID-19). There have been classic clinical cases that have met the case definition of COVID-19 but real-time reverse-transcription polymerase chain reaction (rRT-PCR) tests of nasopharyngeal swabs were negative. OBJECTIVES: This study aimed to share pathological observations of autopsies performed at the 37 Military Hospital's Department of Anatomical Pathology on three presumed COVID-19 cases in Accra, Ghana. METHOD: Complete autopsies with detailed gross and histopathological analysis were conducted between April 2020 and May 2020 on three suspected COVID-19 cases, of which two had initial negative (rRT-PCR) nasopharyngeal tests. Postmortem bronchopulmonary samples of two cases were collected and tested by rRT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). RESULTS: The two postmortem bronchopulmonary samples tested for SARS-CoV-2 by rRT-PCR were positive. Though no postmortem bronchopulmonary sample was taken from the third case, a close contact tested positive for SARS-CoV-2 in later contact tracing. For all three cases, lung histopathological findings were consistent with Acute Respiratory Distress Syndrome. CONCLUSION: The outcome of COVID-19 testing is dependent on the sample type and accuracy of sampling amongst other factors. Histopathological findings vary and may be dependent on a patient's modifying factors, as well as the duration of infection. More autopsies are required to fully understand the pathogenesis of this disease in Ghanaians.

Postmortem diagnosis of COVID-19: Antemortem challenges of three cases at the 37 Military Hospital, Accra, Ghana

Background: Consistency among clinical symptoms, laboratory results and autopsy findings can be a quality measure in the diagnosis of coronavirus disease 2019 (COVID-19). There have been classic clinical cases that have met the case definition of COVID-19 but real-time reverse-transcription polymerase chain reaction (rRT-PCR) tests of nasopharyngeal swabs were negative. Objectives: This study aimed to share pathological observations of autopsies performed at the 37 Military Hospital's Department of Anatomical Pathology on three presumed COVID-19 cases in Accra, Ghana. Method: Complete autopsies with detailed gross and histopathological analysis were conducted between April 2020 and May 2020 on three suspected COVID-19 cases, of which two had initial negative (rRT-PCR) nasopharyngeal tests. Postmortem bronchopulmonary samples of two cases were collected and tested by rRT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: The two postmortem bronchopulmonary samples tested for SARS-CoV-2 by rRT-PCR were positive. Though no postmortem bronchopulmonary sample was taken from the third case, a close contact tested positive for SARS-CoV-2 in later contact tracing. For all three cases, lung histopathological findings were consistent with Acute Respiratory Distress Syndrome. Conclusion: The outcome of COVID-19 testing is dependent on the sample type and accuracy of sampling amongst other factors. Histopathological findings vary and may be dependent on a patient's modifying factors, as well as the duration of infection. More autopsies are required to fully understand the pathogenesis of this disease in Ghanaians