[Etiological diagnosis errors corrected by x-ray computed tomography in acute hemiplegia]

Area of Science:

• Neurology
• Radiology

Background:

• Acute hemiplegia diagnosis relies on clinical assessment, which may not always accurately reflect the underlying etiology.
• Cerebral vascular accidents are a common cause, but other pathologies can mimic stroke symptoms.

Purpose of the Study:

• To correlate clinical diagnoses with etiological diagnoses determined by computerized tomography (CT) in acute hemiplegia.
• To assess the accuracy of clinical diagnosis in identifying the cause of hemiplegia.

Main Methods:

• Retrospective analysis of 248 cases of acute hemiplegia.
• Comparison of clinical admission diagnoses with etiological diagnoses derived from CT scans.

Main Results:

• In 15% of cases, hemiplegia was not caused by a cerebral vascular accident.
• Clinical diagnosis overestimated cerebral vascular accidents in 9% and missed them in 14% of cases.
• Ischemic stroke was overestimated in 15%, and hemorrhage in 45% of cases. CT revealed ischemia in 72% of acute hemiplegias, with 28% due to hematoma, tumor, or subdural hematoma.

Conclusions:

• Clinical assessment alone is insufficient for accurate etiological diagnosis in acute hemiplegia.
• Computerized tomography is crucial for differentiating stroke from other causes like subdural hematoma and tumors.
• Diagnostic discrepancies highlight the need for advanced imaging in managing acute hemiplegia.