Stroke Localization: Clinical Correlation versus Findings of CT Scan Brain in Patients Admitted at Liaquat University Hospital Hyderabad/Jamshoro

OBJECTIVE: To study clinical localization of stroke and correlate with findings on C-T Scan of brain. DESIGN: Observational study. PLACE AND DURATION OF STUDY: The study was conducted at the Medical Department of Liaquat University Hospital Hyderabad/Jamshoro from January 2006 to December 2006. MATERIAL AND METHODS: Total 110 patients with features of stroke were included in this study. These patients were further evaluated for clinical correlation with findings on CT scan brain, done within 24 hours after the development of focal neurological deficit. Brain tumor, meningitis, viral or bacterial encephalitis, multiple sclerosis and metabolic derangements that could explain focal neurological deficit e.g hypoglycemia were` the exclusion parameters. RESULTS: Total of 110 patients, 60 (54.5%) were males and 50 (45.5%) were females. Age of patients ranged 22-84 years with mean±SD age of 53±5 years. On clinical ground cerebral infarction was suspected in 89 (80.9%) and cerebral hemorrhage in 21 (19.1%) patients. In 74 (83%) patients infarction was confirmed by CT scan brain, whereas cerebral hemorrhage was proved in 10 (47.6%) out of a total of 21 patients. These patients were further evaluated for clinical localization of area of stroke. Clinically left parietal / temporo parietal lobe infarction was suspected in 43 patients and right parietal / temporo parietal lobe in 25 patients. Left frontal lobe infarction in 7 patients right frontal lobe infarction in 8 patients, left internal capsule infarction in 2 patients and right internal capsule infarction in 4 patients. Comparing with the CT scan brain findings: left parietal / temporo parietal lobe infarction was confirmed in 41 (95.34%) patients, right parietal / temporo parietal lobe in 19 (76%), left frontal lobe in 5 (71.4%), right frontal lobe in 4 (50%), left internal capsule in 2 (100%) and right internal capsule in 3 (75%) patients. Left middle cerebral artery territory involvement was observed in 43 (58%) patients and right middle cerebral artery territory in 22(30%) patients. No Significant difference was observed in other cerebral artery territories. CONCLUSION: It was concluded from the study that cerebral infarction was more common than hemorrhage and middle cerebral artery territory infarction of both sides was more common than other cerebral artery territories. Localization of stroke on clinical basis is not always easy. Confident diagnosis requires careful case history taking, extensive neurological assessment and with the help of focal neurological deficit of a particular area. CATEGORY: Internal Medicine