Objective:

To describe the neuroimaging patterns in patients aged 18 years or older with stroke in a tertiary-care center in the Dominican Republic (DR).

Background:

Stroke is a major global health concern, ranking second in mortality and third in disability. In the DR, it was the second leading cause of death in 2021, with a rate of 52.3 per 100,000 population. Neuroimaging is essential for rapid classification and early management. Current AHA/ASA guidelines recommend immediate CT/MRI, followed by CTA/MRA/MRV when indicated, to differentiate ischemic from hemorrhagic stroke. No prior studies in the DR have detailed neuroimaging pattern correlations.

Design/Methods:

A retrospective study following STROBE guidelines analyzed medical records of adults >18 years hospitalized with confirmed ischemic or hemorrhagic stroke diagnosed by clinical evaluation and neuroimaging. The primary outcome was the distribution of brain lesions. Secondary outcomes included clinical manifestations, neurological and systemic complications, hospital length of stay, and in-hospital mortality. Cardiovascular risk factors were assessed as exposure variables. Data from clinical notes, nursing records, and neuroimaging reviews were analyzed using JASP 0.16.4.

Results:

A total of 207 patients were analyzed (ischemic = 144; hemorrhagic = 63). Mean age was similar between groups (68.6 ± 14.4 vs. 68.5 ± 13.2, p = 0.770). The parietal lobe was the most affected area in ischemic stroke (40.3%) versus hemorrhagic stroke (14.3%, p < 0.001). The corona radiata showed higher lesion frequency in ischemic cases (11.1% vs. 1.6%, p = 0.022). Deep gray matter, insular, and internal capsule involvement showed no significant differences. Brainstem lesions occurred in one patient per group, and cerebellar involvement was rare (1.4% vs. 3.2%, p = 0.390).

Conclusions:

These findings emphasize the critical role of neuroimaging in accurately differentiating stroke subtypes and support the development of stroke registries to enhance evidence-based management and optimize patient outcomes in the Dominican Republic.