CT Scans and Delays in Diagnosis of Stroke in Senegal’s Regional Hospitals: A Multicenter Study of 655 Cases

• 作者: Abdoulaye Dione Diop Abdoulaye Ndoye Diop Aicha Ndichout Aissata Ly Ba Cherif Mohamadou Aidara El Hadj Niang Fallou Galass Niang Hamidou Deme Ibrahima Faye Léra Géraud Akpo Malick Diouf Mamadou Ly Marie Mbengue Mouhamadou Hamine Toure Ndiaga Matar Gaye Nfally Badji Oumou Dieng Ousmane Cissé Ousmane Sano Sokhna Ba Diop
• 来源期刊: 医学影像期刊(英文)
• 学科: 医学
• 关键词: STROKE CT Scans Diagnostic Delays
• 年，卷（期）: 2020,（2）
• 页码范围: 96-104
• 页数: 9页
• 分类号: R74

摘要

Stroke represents the 2^nd cause of mortality and 1^st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. <b>Objective: </b>To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. <b>Materials and Methods: </b>This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan.<b> Results: </b>655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. <b>Conclusion: </b>CT is c