Neuroimaging Findings in Stroke with Clinical Correlation

Objective: This study was done to evaluate the neuroimaging findings in stroke and to correlate clinical findings with the neuroimaging findings. Methods : A prospective hospital based cohort study was done of 250 patients with provisional clinical diagnosis of recent stroke who underwent neuroimaging (CT/MR). Patients with neurologic deficit due to trauma, hypoxic injury or suspected substance abuse were excluded. Imaging findings were evaluated and tabulated independently and subsequently correlated with the clinical findings from the available patients records. Results : The study showed male predominance (male patients 59%) and maximum number of patients belonged to sixth decade (27.6 %). Infarcts (172 cases, 70%) were more common than hemorrhage (78 cases, 30%). Arterial infarcts (167 cases, 97 %) were predominant with involvement of MCA territory in 70 cases (39%). In cases of hemorrhagic stroke basal ganglia complex was the commonest location for hemorrhage (57 cases, 84 %). Clinical diagnosis in cases of ischemic stroke had Senstivity of 68%, Specificity 93 %, Positive Predective Value 96 % and Negative Predective Value 56 %. While in cases of hemorrahagic stroke the clinical diagnosis had sensitivity of 90.8%, Specificity 80.5%, Positive Predective Value 67% and Negative Predective Value 95.2 %. Conclusion: Ischemic stroke was more common than hemorrhagic stroke across all age groups. MCA territory infarcts and gangliothalamic bleed were the most common presentation in ischemic and hemorrhagic strokes respectively. There was significant concordance between clinical diagnosis and imaging findings. Clinical diagnosis had higher specificity for ischemic stroke while the sensitivity was higher for hemorrhagic stroke.