Evaluation of CT Brain Reporting Accuracy for Stroke Detection at Teaching Hospitals in Kwara State, North Central Nigeria

Computed tomography of the brain is the first-line imaging investigation for suspected stroke, and accurate and timely CT brain reporting directly determines thrombolysis eligibility and clinical management decisions. At teaching hospitals in Kwara State, North Central Nigeria, where stroke burden is significant and neuroimaging interpretation capacity is limited, the accuracy of CT brain reporting for acute stroke detection warrants systematic evaluation. This study evaluates the accuracy of CT brain reports for stroke detection at University of Ilorin Teaching Hospital and General Hospital Ilorin. A retrospective comparative design is applied to 200 CT brain reports from suspected stroke cases from 2021 to 2023, comparing initial report diagnoses against final clinical diagnoses determined by the treating neurology team. Sensitivity, specificity, and positive predictive value for acute ischaemic and haemorrhagic stroke detection are calculated using SPSS. Available stroke imaging literature from North Central Nigeria identifies haemorrhagic stroke detection as significantly more sensitive than ischaemic stroke on initial plain CT, with early ischaemic signs frequently missed in the hyperacute period. The Alberta Stroke Programme Early CT Score provides the structured analytical reference for ischaemic stroke CT characterisation. Findings are expected to reveal high haemorrhagic stroke detection sensitivity alongside lower ischaemic stroke sensitivity, particularly within the first three hours of onset. Recommendations address ASPECTS scoring training for radiographers and radiologists, CT brain stroke protocol implementation, and teleneurology reporting consultation pathways at Kwara State teaching hospitals. Keywords: CT brain, stroke detection, reporting accuracy, Kwara State, North Central Nigeria.