Head computed tomography scan patterns of patients suspected to have cerebrovascular disease at Moi Teaching and Referral Hospital –Eldoret, Kenya

Abstract

Background: Cerebrovascular disease (CVD) is a major cause of morbidity and mortality in both developed and developing countries due to aberrant and emerging trends in lifestyle. With rapid scan times and software aided ease of linear attenuation coefficients calculation, Computed tomography (CT) scanners are preferred for imaging CVDs. In spite of these, CVD patterns have not been established at Moi Teaching and Referral Hospital (MTRH), Kenya. Objective: To describe the brain CT scan patterns of patients suspected to have CVD at MTRH. Methods: This was a descriptive cross-sectional study done at Moi Teaching and Referral Hospital-Kenya from October 2014 to July 2015 where consecutive sampling technique was used on consenting patients with a clinical diagnosis of CVD who had CT scans. A structured questionnaire which had socio-demographic characteristics, signs and symptoms was administered to participants. Findings on CT scan and HU characteristic were noted and filled by interviewer into the questionnaire. Categorical variables were summarized as frequencies with corresponding percentages while continuous variables were summarized as median and the corresponding inter quartile range given. Data analysis and statistical computing was done with R Core Team software and results were presented in tables and graphs. Results: A total of 225 participants were included in the study. The median age was 60.0 (IQR: 44.0, 77.0) years with a minimum and a maximum of 2.0 and 102 years respectively. One hundred and eighteen (52.4%) were male. More than a third of the participants, 36.9% had ischemic stroke, and 27 (15.1%) suffered hemorrhagic stroke. Cerebral atrophy was diagnosed in 41 (23.0%) of the participants. Forty two, 23.5%, of the total participants had normal CT, and 9 (5.0%) were diagnosed of tumors. Of those specifically with stroke, ischemic types were 66(71.1%) with an average HU of 18.0+/- 8.6 and hemorrhagic stroke 27(28.9%) and average HU of 60.8+/- 9.1. Majority, 26 (11.6%), of the CVD scan patterns were located in the parieto-temporal region. Conclusion: The most common CT scan finding of patients suspected to have CVD was ischemic stroke and the average HU for Ischemic stroke was 18.0+/- 8.6 and 60.8+/- 9.1 for hemorrhagic stroke. Recommendation: The use of Hounsfield Unit values in characterization of stroke is recommended.