Evaluation of Brain Computerized Tomography Scan in Patients with Acute Ischemic stroke


Background: Stroke remains one of the leading cause of the death in the world and despite the advance in neuroimaging, computerized tomography (CT) is still widely used in evaluation of patients with ischemic stroke in emergency unit which should be done before giving thrombolytic therapy in the first 3-4.5 hour of stroke onset .Aim of this study is to evaluate early brain CT findings among ischemic stroke which is of great help in deciding early stroke management. Patients and methods: A cross-sectional descriptive study was done at Middle Euphrates Neuroscience center; AL-Sadder Medical City at Annajaf city – Iraq, in the period from may 2012 to December 2014. A total of 108 patients whom clinically diagnosed as stroke were referred for CT scan of brain within 48 hours of the stroke onset. Twelve patients with intracranial hemorrhages were excluded and the remaining 96 patients were studied for early brain CT findings. Results: The prevalence of ischemic infarction was 85%, with slight male predominance (male: female ratio=1.25:1) and most affected patients with ischemic type were in range of 60-69 years. The sensitivity of CT scan in detection of the ischemic changes increased linearly with time from onset of stroke. The prevalence of the hyperacute signs of middle cerebral artery infarction (insular- ribbon sign and hypodense basal ganglia) in acute ischemic stroke were seen in 33.3%, no case reported to show hyper dense middle cerebral artery sign in our study. Conclusion: CT remains the initial imaging modality of choice for the early diagnosis and management of acute stroke especially in making the diagnosis within the therapeutic window for thrombolytic therapy where the time is crucial for detectability. Specific signs of hyperacute infarction should be carefully scrutinized for early detection.