Computerised tomographic scan of the head in evaluation of stroke in Ghanaians

One thousand and three patients clinically diagnosed as stroke cases were investigated using computerised tomographic (CT) scan. No diagnosis was made in 56 (5.58%) of the patients. While 56 cases had the CT scans reported as normal, in 40 (4.99%) of the patients disorders other than stroke were diagnosed. They included remediable causes like subdural haematoma (ten cases), cerebral abscess (eight cases), meningioma (four cases), other brain tumours (eighteen cases). Nine hundred and seven of the patients were proven to have suffered a stroke; 547 (60.3%) were haemorrhagic and 360 (39.7%) were infarctive. These results are at variance with previous studies from West Africa which made infarcts the commoner stroke type, but reflect those found in Blacks elsewhere in South Africa and America. Our results were achieved through the use of the CT scan as opposed to the earlier clinically-diagnosed West African studies. The larger number of haemorrhagic strokes had therapeutic implications. Trepidation in the use of anticoagulants, thrombolytics and fibrinolytics before proof of the pathological type is advised. Although clinical evaluation may be more cost-effective in the management of stroke, brain imaging techniques are recommended for accuracy in diagnosis and appropriate management.