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

作     者：Hamidou Deme Nfally Badji Léra Géraud Akpo Oumou Dieng Abdoulaye Dione Diop Fallou Galass Niang Mouhamadou Hamine Toure Ibrahima Faye Malick Diouf Aicha Ndichout Marie Mbengue Cherif Mohamadou Aidara Mamadou Ly Ousmane Sano Ndiaga Matar Gaye Ousmane Cissé Abdoulaye Ndoye Diop Aissata Ly Ba Sokhna Ba Diop El Hadj Niang Hamidou Deme;Nfally Badji;Léra Géraud Akpo;Oumou Dieng;Abdoulaye Dione Diop;Fallou Galass Niang;Mouhamadou Hamine Toure;Ibrahima Faye;Malick Diouf;Aicha Ndichout;Marie Mbengue;Cherif Mohamadou Aidara;Mamadou Ly;Ousmane Sano;Ndiaga Matar Gaye;Ousmane Cissé;Abdoulaye Ndoye Diop;Aissata Ly Ba;Sokhna Ba Diop;El Hadj Niang

作者机构：Radiology Department of the Aristide Le Dantec Hospital in Dakar Dakar Senegal Radiology Department of the CHNU de Fann in Dakar Dakar Senegal Neurology Department of the Fann University Hospital in Dakar Dakar Senegal Radiology Department of the Albert Royer Children’s Hospital of Fann in Dakar Dakar Senegal 

出 版 物：《Open Journal of Medical Imaging》 (医学影像期刊（英文）)

年 卷 期：2020年第10卷第2期

页      面：96-104页

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：Stroke CT Scans Diagnostic Delays 

摘      要：Stroke represents the 2nd cause of mortality and 1st 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. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. Materials and Methods: 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. Results: 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