Spontaneous intracranial haemorrhage: computed tomographic patterns in Accra

Area of Science:

• Neurology
• Radiology
• Public Health

Background:

• Accurate stroke diagnosis and subtype differentiation are crucial for patient management.
• Stroke prevalence and subtype incidence vary geographically and demographically.
• Computed Tomography (CT) is a vital imaging modality for diagnosing stroke and its subtypes.

Purpose of the Study:

• To investigate the prevalence and characteristics of stroke (cerebrovascular accident - CVA) in the Ghanaian population.
• To determine the incidence of different stroke subtypes, specifically spontaneous intracranial hemorrhage versus cerebral infarcts.
• To analyze demographic factors such as age and gender associated with stroke in this cohort.

Main Methods:

• Retrospective analysis of CT scans from 1,172 stroke patients in Ghana.
• Classification of stroke subtypes: spontaneous intracranial hemorrhage and cerebral infarcts.
• Detailed examination of hemorrhage characteristics, including type, location, ventricular extension, and associated findings like edema and mass effect.

Main Results:

• Stroke (CVA) is prevalent among Ghanaians, with a higher incidence of spontaneous intracranial hemorrhage (52.9%) compared to cerebral infarcts.
• The study observed a male preponderance with a mean age of 55.7 years.
• Parenchymal hemorrhage was the most common type (83.6%), often unilateral and left-sided, particularly in the parietal lobe. Cerebellar and pontine hemorrhages were also identified. Associated findings included significant parilesional edema (87.1%) and mass effect (77.4%).

Conclusions:

• CT imaging effectively diagnoses various stroke subtypes, including those in challenging locations like the cerebellum and pons.
• Hemorrhagic stroke is more common than ischemic stroke in the studied Ghanaian population.
• The findings highlight the importance of neuroimaging in understanding stroke epidemiology and characteristics in specific ethnic groups.