TIME OF PRESENTATION OF STROKE PATIENTS FOR CT IMAGING IN A NIGERIAN TERTIARY HOSPITAL

Area of Science:

• Neurology
• Radiology
• Public Health

Background:

• Neuroimaging is crucial for guiding acute stroke therapies, which have narrow time windows for optimal outcomes.
• Delayed patient presentation in developing countries like Nigeria poses a significant challenge to timely stroke management.
• This study investigated stroke patient presentation times for CT imaging in a Nigerian tertiary hospital.

Purpose of the Study:

• To determine the time and pattern of stroke patient presentation for CT imaging.
• To assess the proportion of stroke patients presenting within critical time windows for intervention.
• To identify factors influencing delayed presentation for stroke imaging.

Main Methods:

• Retrospective analysis of 83 stroke patients who underwent cranial CT between 2008 and 2010.
• Categorization of patients into time groups based on symptom onset to CT imaging.
• Cross-tabulation of presentation times with CT findings (infarction, hemorrhage, normal).

Main Results:

• Cerebral infarction was diagnosed in 50.6% of patients, and hemorrhagic stroke in 27.7%.
• The mean presentation time for CT imaging was 70 hours; only 31% presented within 12 hours, and none within 3 hours.
• Ischemic stroke patients (72.3%) presented significantly later than hemorrhagic stroke patients (27.7%) (P=0.045).

Conclusions:

• No patients met the time criteria for thrombolytic therapy due to late presentation.
• Ischemic stroke patients showed a trend towards later presentation compared to hemorrhagic stroke patients.
• Enhanced public awareness and improved healthcare-seeking behaviors are vital for early stroke recognition and intervention in Nigeria.