Author(s)

Hamidou Deme^1*, Nfally Badji¹, Léra Géraud Akpo¹, Oumou Dieng¹, Abdoulaye Dione Diop², Fallou Galass Niang², Mouhamadou Hamine Toure², Ibrahima Faye¹, Malick Diouf¹, Aicha Ndichout², Marie Mbengue¹, Cherif Mohamadou Aidara², Mamadou Ly², Ousmane Sano², Ndiaga Matar Gaye³, Ousmane Cissé³, Abdoulaye Ndoye Diop², Aissata Ly Ba⁴, Sokhna Ba Diop², El Hadj Niang¹

¹Radiology Department of the Aristide Le Dantec Hospital in Dakar, Dakar, Senegal.
²Radiology Department of the CHNU de Fann in Dakar, Dakar, Senegal.
³Neurology Department of the Fann University Hospital in Dakar, Dakar, Senegal.
⁴Radiology Department of the Albert Royer Children’s Hospital of Fann in Dakar, Dakar, Senegal.

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. 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 24 hours in 18.5%. Conclusion: CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management.

Stroke, CT Scans, Diagnostic Delays

Deme, H. , Badji, N. , Akpo, L. , Dieng, O. , Diop, A. , Niang, F. , Toure, M. , Faye, I. , Diouf, M. , Ndichout, A. , Mbengue, M. , Aidara, C. , Ly, M. , Sano, O. , Gaye, N. , Cissé, O. , Diop, A. , Ba, A. , Diop, S. and Niang, E. (2020) CT Scans and Delays in Diagnosis of Stroke in Senegal’s Regional Hospitals: A Multicenter Study of 655 Cases. Open Journal of Medical Imaging, 10, 96-104. doi: 10.4236/ojmi.2020.102009.