Different Pattern of Presentation of Acute Stroke and Their Relation with Neuroimaging

Open Access

Abstract

Background: Stroke is a leading cause of mortality and disability worldwide, with a high burden in low- and middle-income countries. Early differentiation between ischemic and hemorrhagic strokes is crucial because management strategies differ. Understanding the relationship between clinical presentation and CT findings is essential in stroke care. Objective: To evaluate the clinical presentation patterns in patients with acute stroke and assess their relationship with CT-confirmed neuroimaging findings. Methods & Materials: This cross-sectional observational study was conducted at the Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from October 2015 to March 2016. A total of 100 patients with stroke were included in the study. Clinical evaluation was performed, followed by non-contrast CT of the brain. The associations between clinical features and stroke subtypes were analyzed using chi-square tests. Results: Most patients were aged 51–70 years, with a male predominance. Hemiplegia was the most common presenting feature in both ischemic and hemorrhagic stroke. Headache, vomiting and neck rigidity were significantly more frequent in hemorrhagic stroke. Severe impairment of consciousness was also more common in hemorrhagic cases. Clinical diagnosis showed high accuracy compared to CT findings. CT localization revealed basal ganglia and thalamic predominance in hemorrhagic stroke, whereas cortical involvement was more frequent in ischemic stroke. Conclusion: Although the clinical features overlap between stroke subtypes, certain symptoms and consciousness levels suggest hemorrhagic stroke. CT imaging remains indispensable for definitive diagnosis and should be prioritized in acute stroke management.