Evaluation of the Anatomical Locations of Stroke Events From Computed Tomography Scan Examinations in a Tertiary Facility in Ghana

Abstract

IntroductionStroke events are leading causes of mortalities globally and currently increasing alarmingly in low-and middle-income nations including Ghana, thus overburdening national healthcare delivery sectors. This trend is predicted to ultimately have an impact on the socio-economic development of these countries, thus gaining the attention of policy-makers and implementers. This study was therefore conducted to evaluate the anatomical locations of stroke events from CT scan examinations and the possibly associated variables to assist in managing this non-communicable pandemic. MethodsAll computed tomography (CT) scans performed for stroke events at the Cape Coast Teaching Hospital from June 2016 to June 2020 were retrieved and reviewed for this study. The socio-demographics and the presence of hypertensive risk factor were also retrieved. Data were then collated, grouped, coded, inputted, and used for analysis. Chi-square test of independence was employed for assessing possible associations, and logistic regression analysis was performed to predict the anatomical locations of stroke events using sex and hypertension. Statistical significance level was specified at p ≤ 0.05. ResultsA total of 1,750 stroke cases were recorded during the study period, comprising 1,237 (70.7%) ischemic strokes and 513 (29.3%) hemorrhagic strokes. Majority (54.3%) of the patients were males. The average age of participants was 62.46±14.74 years. Basal ganglia (43.0%), parietal lobe (26.7%), and frontal lobe (6.9%) were the commonest anatomical locations. The elderly (≥ 60 years) were significantly affected at the basal ganglia (p=0.006), parietal lobe (p=0.005), frontal lobe (p=0.013), temporal lobe (p=0.048), and cerebellum (p=0.049). Basal ganglia lesions were significantly recorded in men, whereas lesions located at the pons were significantly seen in females. The regression model revealed that the risk of stroke at the pons increased by 2.155-folds in males (p=0.043; 95% CI=1.026-4.528). Generally, gender and hypertension were not significant predictors of stroke lesion locations. ConclusionsThe basal ganglia area, which falls under the middle cerebral artery territory, was the commonest anatomical location for stroke events in our setting. Knowing the anatomical locations of these stroke events has an impact on the type of interventions needed, especially at the early stages of these stroke events. CT perfusion, CT angiography, and magnetic resonance imaging (MRI) with MR angiography (MRA) when available can further assist in determining the exact cause so that urgent interventions such as endovascular treatments can be offered.

Spectrum of Intracerebral Hemorrhage in a Tertiary Hospital

“…al, have stated in their study that basal ganglia region was most common site of ICH followed by patietal lobe, frontal lobe, temporal lobe and cerebellum in descending order. 10 Basal ganglia region that includes putamen, caudate and thalamus were the most common site of bleeding in our study as well. Study on prevalence of thalamic hematoma have reported ranging from 6% in series of Juvela et al 11 to 15.7% in series of tatu et al 12 Kumral et al have reported prevalence of thalamic hematoma as 25.6%.…”

Computed tomography features of spontaneous acute intracranial hemorrhages in a tertiary hospital in Southern Ghana

“…Strokes are generally known to be a significant cause of morbidity and mortality in the world and Africa in particular. Its incidence has been reported to be increasing with increasing age and as the years go by [ 16 , 21 ]. Therefore, the findings from this current study emphasize the essence of knowing the radiological features of CT scan for SICH in order to enable quick and accurate diagnosis, as the management of such events depends on how early the diagnosis is made.…”

“…However, the introduction of CT in 1972, has significantly improved the accuracy and diagnosis of intracranial hemorrhage, and has become the neuro-imaging modality of choice in the assessment of SICH [ 2 , 12 , 13 ]. Even though CT scan has been reported in a recent study in Ghana as one of the most available imaging modalities in radiological practices and hence the most employed modality for neuroimaging, there are some challenges like relatively high cost, frequent power failures and few others which may end up delaying early detection of SICH [ 14 - 16 ]. Therefore, we aimed at analyzing the CT scan patterns in patients with spontaneous intracranial hemorrhage in a tertiary care hospital located in the Central Region of Ghana.…”

Editor’s choice: Infections, non-communicable diseases, and reproductive health issues in a world beset by conflict and climate change

“…Others cover a host of subjects ranging from goiter 37 , alloimmunization 38 , kidney diseases 39 and trauma 40 . The next set of papers, is on sexual reproductive health [41][42][43][44][45][46][47][48][49][50][51][52] . The rest are on nutrition [53][54][55] , mental health [56][57][58] and a couple of hybrid issues [59][60][61][62] .…”