Background: Scoring systems based on discriminant analysis technique
and multivariate logistic regression have been developed to distinguish
cerebral haemorrhage (CH) from cerebral infarction (CI). This
distinction is necessary in the acute management of stroke patients.
The Siriraj stroke score (SSS) was evaluated in Siriraj hospital,
Bangkok, and the Western Infirmary, Glasgow, and needs to be validated
in an African setting. Methodology: The computerised tomography (CT)
brain scans of all patients referred with clinical diagnosis of stroke
at the University College Hospital (UCH), Ibadan, and RADMED diagnostic
centre, Lagos were retrieved and reviewed as well as the case notes of
the patients at the referral hospitals. The SSS was computed and the
stroke subtype classified. This was compared with the CT scan diagnosis
using the latter as the gold standard. Data analysis was performed with
Epi-info software and by standard statistical methods. Results:
Ninety-six patients had complete clinical records and CT scan features
consistent with stroke. Of these, 52 had cerebral infarction (CI) and
44 had cerebral haemorrhage (CH). SSS had sensitivity of 50% for CH and
58% for CI with an accuracy of 54.2%. Conclusion: In this study, the
SSS was not sufficiently sensitive to differentiate between CH and CI
in Africans. A prospective study with larger sample size and
modification of the discriminant variables is suggested. For now, while
efforts must continue to find a simple clinical scoring system to
differentiate between CH and CI, we contend that CT scan should remain
the investigative technique of choice and should be made affordable and
available
