Neuroimaging of brain stroke in Kirkuk: Etiology, Accuracy and Clinical features
Brain Imaging
Keywords:
Stroke, neuroimaging, ischemic stroke, computed tomography, magnetic resonance imaging, risk factors, Kirkuk, cerebrovascular accident, aphasia, small vessel diseaseAbstract
Background: Stroke remains the second leading cause of death globally, with approximately 90% of cases classified as ischemic strokes. Neuroimaging plays a pivotal role in the diagnostic framework, yet formal studies correlating radiological findings with clinical features remain limited, particularly in resource-limited settings such as Kirkuk, Iraq.
Objective: This study aimed to comprehensively evaluate the role of neuroimaging in diagnosing brain stroke, identify underlying etiologies within the local population, and establish correlations between radiological findings and clinical patient presentations.
Methods: A clinical cross-sectional study was conducted at Kirkuk Teaching Hospital and Azadi Teaching Hospital, involving 36 patients presenting with acute neurological manifestations suggestive of cerebrovascular accident. Data collection included demographic characteristics, lifestyle factors (smoking, physical activity, diet), clinical neurological examination, medical history, and neuroimaging findings using non-contrast CT (NCCT), MRI, and neurological ultrasound. Statistical analysis was performed using SPSS with descriptive statistics.
Results: The sample comprised 61.1% males and 38.9% females, with 50% of patients aged 60 years or older. Left-sided weakness was the most common physical symptom, while expressive aphasia occurred in 83.3% of cases, and right-sided visual changes in 75%, indicating dominant hemisphere involvement. Most patients presented within the critical 1–3 hour "golden period." Males demonstrated higher physical activity (59.5%) but also significantly higher smoking rates (over 77% with smoking history) and fatty diet consumption (40.9%). High blood cholesterol was the leading risk factor in males (22.7%), while high blood sugar predominated in females (21.4%). NCCT was the primary imaging modality (91.7% of cases). Acute ischemic changes were observed in 53.9% of patients, with left middle cerebral artery infarction being the most common finding. Chronic changes, particularly deep white matter hyperintense signals, were present in 30.6% of patients, indicating underlying small vessel disease.
Conclusion: Stroke in Kirkuk predominantly affects older males with high burdens of modifiable risk factors, particularly smoking, high-fat diet, and hyperlipidemia. The high prevalence of chronic small vessel disease suggests long-standing untreated vascular pathology. Gender-specific prevention strategies, enhanced MRI utilization, and strengthened acute stroke response systems are urgently needed to improve diagnostic accuracy and patient outcomes in the region.
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