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ORIGINAL ARTICLE
Year : 2013  |  Volume : 27  |  Issue : 3  |  Page : 216-221

A comparison of clinical diagnosis with Computed Tomography findings in stroke patients


Department of Medicine, RIMS, Imphal, Manipur, India

Correspondence Address:
Tomar Nyodu
Department of Medicine, RIMS, Imphal - 795 004, Manipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-4958.127397

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Objective: To compare clinical diagnosis with computed tomography findings in identifying the types of stroke. Materials and Methods: The study was carried out after obtaining approval from the Institutional Ethical Committee, in the Department of Medicine, RIMS, Imphal, Manipur, from October 2010 to September 2012. The study sample consisted of 150 patients presenting with first-ever acute stroke who were clinically evaluated. An interviewer-structured questionnaire was administered and Siriraj stroke score computed. Clinical diagnosis of stroke-type (hemorrhagic or ischemic) was made based on Siriraj stroke score. The stroke-type was classified and compared with CT scan diagnosis. Data were analyzed using SPSS 16 software. Results: There were 150 patients in the study sample, out of them, 71 were hemorrhagic stroke patients and remaining 79 were ischemic stroke patients diagnosed by CT scan. The correlation between stroke-type, headache, level of consciousness at presentation, vomiting, and diastolic blood pressure achieved statistical significance. Sensitivity, specificity, positive predictive value, and negative predictive values of Siriraj stroke score for cerebral hemorrhage were 78.87%, 91.13%, 88.88%, and 82.75%, respectively. Conclusion: Hemorrhagic and ischemic stroke cannot be distinguished clinically with a simple clinical evaluation, and it is virtually impossible for all stroke patients to have a computed tomography scan immediately after admission, especially in rural area. When computed tomography is not immediately available and the clinician wishes to start anti-thrombotic treatment, the clinical diagnosis based on the Siriraj stroke score can be useful to identify patients at low risk of intracerebral hemorrhage.


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