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Stroke Mimics - A Study of CT images in Nigerian African Stroke Patients

机译：中风模拟物-尼日利亚非洲中风患者的CT图像研究

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Background: Stroke is a major cause of morbidity and mortality worldwide. In African countries stroke accounts for 4-9% of deaths and between 6.5- 41% of neurological admissions in hospital based studies.[] Sophisticated neuroimaging modalities for the investigation of suspected stroke have been available especially in developed societies thus enhancing the accurate diagnosis of stroke in many cases. However in sub Saharan Africa these facilities are found in very few centres. In Nigeria, the country with the largest black population, computerized tomography became available in few centres only in the recent years and is largely unaffordable for most patients with stroke. Aim: This retrospective study sought to examine the computerized tomography findings in Nigerian patients with a prior clinical diagnosis of stroke and to establish a comparison between the radiological and clinical diagnosis of stroke as made by the physicians with a view to identifying stroke mimics.Methodology: A retrospective review was done of the medical and computerized tomography records of all patients with a clinical diagnosis of stroke who were referred to the Memfys Hospital for Neurosurgery Enugu for brain scan over a four and half year period (January 2003- June 2007). The data obtained was analysed using Statistical Package for the Social Sciences version 11.Results: A total of 2207 patients had brain scan over the period with 142 (6.4%) being referred with a prior diagnosis of stroke. There were more males 102(71.8%) than females 40(28.2%). The mean age of the patients was 54.4 years. Computerized tomography scan confirmed the clinical diagnosis of stroke in 93 patients (65.5%) while 33 patients (23.2%) had stroke mimics. A negative scan was found in 16 patients (11.3%). The clinical accuracy for stroke diagnosis was thus 65.5% while diagnostic errors were made in 34.5% of the patients especially those at extremes of age. Conclusion: Despite the use by physicians of clinical scoring systems in the diagnosis of stroke in Africa, it is evident that a significant rate of misdiagnosis exists with potential implications for the provision of adequate care of patients. There is a need to improve the accessibility and affordability of CT scan in the continent.How to cite this article:I. O ONWUEKWE, B. A E.-ADIKAIBE, S. C OHAEGBULAM, M. C CHIKAN?, J. AMUTA, H. N ULOH: Stroke Mimics - A Study of CT images in Nigerian African Stroke Patients. J Neurol Sci [Turk] 2008;25:148-154How to cite this URL & PDF:I. O ONWUEKWE, B. A E.-ADIKAIBE, S. C OHAEGBULAM, M. C CHIKAN?, J. AMUTA, H. N ULOH: Stroke Mimics - A Study of CT images in Nigerian African Stroke Patients. J Neurol Sci [Turk] 2008 [cited 2008 September 25];25:148-154. Available from: http://jns.dergisi.org/text.php3?id=226 PDF: http://jns.dergisi.org/pdf/pdf_JNS_226.pdfE-mail of the corresponding author: onwuekweio@yahoo.com
机译：背景：中风是全世界发病率和死亡率的主要原因。在非洲国家，以医院为基础的研究表明，卒中占死亡人数的4-9％，占神经科住院患者的6.5-41％。[]复杂的神经影像学方法可用于研究可疑的卒中，特别是在发达社会中，从而提高了准确性在许多情况下可诊断为中风。但是在撒哈拉以南非洲，这些设施很少见。在尼日利亚这个黑人人口最多的国家，计算机断层扫描技术仅在最近几年才在少数几个中心得到使用，并且对于大多数中风患者而言，这在很大程度上是买不起的。目的：这项回顾性研究旨在检查尼日利亚先前有中风临床诊断的患者的X线断层扫描结果，并确定医生对中风的放射学诊断和临床诊断之间的比较，以识别中风的模仿物。回顾性回顾了所有临床诊断为中风的患者的医学和计算机断层扫描记录，这些患者在四年半的时间里（2003年1月至2007年6月）被转诊至Enum的Memfys神经外科医院进行脑部扫描。使用《社会科学统计软件包》第11版对获得的数据进行分析。结果：在此期间，共有2207例患者进行了脑部扫描，其中142例（6.4％）被诊断为中风。男性102（71.8％）比女性40（28.2％）多。患者的平均年龄为54.4岁。计算机断层扫描确认了93例中风的临床诊断（65.5％），而有33例（23.2％）的患者具有中风模仿。 16例患者扫描阴性（11.3％）。因此，中风诊断的临床准确性为65.5％，而34.5％的患者尤其是极端年龄的患者发生了诊断错误。结论：尽管医师在非洲中风的诊断中使用了临床评分系统，但很明显，存在很大的误诊率，可能对提供足够的患者护理产生潜在的影响。有必要提高非洲大陆CT扫描的可访问性和可负担性。 O ONWUEKWE，B。A. E.-ADIKAIBE，S。C. OHAEGBULAM，M。C. CHIKAN？，J。AMUTA，H。N ULOH：卒中模拟物-尼日利亚非洲卒中患者的CT图像研究。 J Neurol Sci [Turk] 2008; 25：148-154如何引用此URL和PDF：I。 O ONWUEKWE，B。A. E.-ADIKAIBE，S。C. OHAEGBULAM，M。C. CHIKAN？，J。AMUTA，H。N ULOH：中风模拟物-尼日利亚非洲中风患者的CT图像研究。神经科学杂志（Turk）2008年[引自2008年9月25日]; 25：148-154。可从以下网址获得：http://jns.dergisi.org/text.php3?id=226 PDF：http://jns.dergisi.org/pdf/pdf_JNS_226.pdf相应作者的电子邮件：onwuekweio@yahoo.com

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