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Cerebrovascular disease (CVD) is one of the three leading causes of death in the world along with cancer and heart disease. CVD or stroke is a major cause of morbidity and mortality. For any treatment to be contemplated it is important to know whether we are dealing with a bleed or an infarct. Differentiation between cerebral infarction and intracerebral hemorrhage is necessary nowadays for proper management of acute stroke syndrome based on the correct diagnosis of the pathological type. This study compared clinical and CT scans diagnosis of stroke and determined the clinical reliability of the clinical diagnosis in cases of stroke. This study was conducted retrospectively on 257 patients. CT scan was requested to rule out nature of acute cases of stroke for one year duration at Hospital Duchess of Kent (HDOK) from July 2006 to June 2007. Clinical diagnosis was made in conformity with criteria for clinical diagnosis of intracranial hemorrhage, cerebral infarction due to embolism or thromboses. The CT scan findings were compared with clinical diagnosis of stroke. The patients included 148 males and 109 females with an age range of 11 to 90 years. Clinically, 91(35.40%) subjects were suspected to have cerebral infarction, 64(24.60%) intracerebral bleed and 102(40%) indeterminate. CT scan brain showed 174 (67.96%) cases of abnormal findings and 83 (32.29%) cases of normal findings other than different degree of degenerative changes. Out of 174 cases of abnormal findings, CT showed 119 (46.31%) cases of cerebral infarction, 52 (20.23%) cases of cerebral hemorrhage and 3 (1.17%) cases of space occupying lesion subjects. In order to make a clinical diagnosis of stroke, a detailed history, thorough clinical examination and to follow the definite criteria chart for stroke to be diagnosed is mandatory as well as to avoid unnecessary CT request of brain which are more concerned with radiation hazard and cost. As far as treatment planning is concerned clinical diagnosis .....
Bhuiyan et al. (Wed,) studied this question.