– Ž‡ƒ•– ʹͳͺ ‡ƒ ™ƒ–‹ †‹ƒ‰‘•‡† ™‹–Š •–”‘‡ ‹ ʹͲʹʹ
MBABANE – Around 218 emaSwati were diagnosed with different forms of strokes in 2022, at Mbabane Government Hospital.
This is according to findings of a study presented by Professor Jae Hyung Park on Friday during the neurological disorders conference.
The second hybrid conference was organised by the Health Care Improvement Project (HCIP) in Taiwan Medical Mission (TMM). Other workshops that had been organised by the TEHCI include epilepsy workshops, autism workshops, advanced cardiovascular life support, neonatal resuscitation programme and point-of-care ultrasound hands-on course, as well as medical educational activities for years.
Invited speakers addressed the clinical status in the Kingdom of Eswatini, shared experiences and also updated the clinical knowledge including pathophysiology, pharmacology, and management.
Conference
The neurological disorders conference focused on stroke. According to speakers that included medical practitioners from Taiwan and emaSwati, Stroke rose from fifth to forth position in the list of leading causes of death in Eswatini during last decade.
The conference, therefore, focused on the acute management of stroke.
The algorithm is based on advanced cardiac life support and AHA guideline 2020, which explains the time window of assessment and treatment at emergency departments.
Park stated that emaSwati were at risk of Hemorrhagic stroke, which is a type of stroke that has a relatively high fatality rate.
This is a type of condition which a ruptured blood vessel, causes bleeding inside the brain. High blood pressure and trauma are the two leading causes of this stroke.
He noted however, that this condition could be easily diagnosed with non-contrast computer tomography (CT) scan as a high-density lesion.
The professor said with the aim of reducing the deaths caused by all types of strokes in Eswatini, they embarked on an exercise with the department of radiology at Mbabane Government Hospital and conducted non-contract CT scans. This form of scan may identify the early signs of stroke but, most importantly, will exclude intracerebral haemorrhage and lesions that might mimic acute ischemic stroke, such as tumour or intracerebral haemorrhage.
He stated that during the course of the exercise, they conducted 2 255 non-contrast CT scans, of which 218 were diagnosed with stroke. “Of the 218 patients, 200 patients were diagnosed with ischemic stroke, and 18 patients, which were equivalent to 8.3 per cent, were diagnosed with hemorrhagic stroke,” he said. He clinician stated that among the 18 patients with hemorrhagic stroke, 11 were males while seven were females.
In terms of the age, Park said they ranged between 31 to 83 years, with a mean of 61.4 years.
The location of the stroke, he said, was one multiple bilateral in two patients, two right cerebral hemisphere (refers to the sides of the brain) in seven patients, including three basal ganglia haemorrhages and three intraventricular haemorrhages, three left cerebral hemisphere in nine patients, including seven basal ganglia haemorrhages and two intraventricular haemorrhages. Meanwhile, in associated brain CT findings, nine patients were found with a subfalcine herniation, and five with two different intraventricular haemorrhage.
Patients
Other findings included ischemic infarct in three patients, four chronic ischemic infarct in two patients, five brain atrophy in two patients, six obstructive hydrocephalus in one patient, and seven HIV encephalopathy in one patient.
“A timely and accurate diagnosis of haemorrhagic stroke with non-contrast CT is highly recommended for proper management. The incidence of this condition and CT findings of the haemorrhagic stroke in this study could be a reference to the further study for the stroke in Eswatini and Southern Africa,” he said.
He highlighted that the findings indicated the need to conduct more studies on this form of strokes in order for the country to be able to add medication that is currently not part of the treatment of stroke.