Background: Stroke remains a major cause of mortality and long-term disability worldwide, particularly in developing countries where access to advanced neuroimaging may be limited. Computed Tomography (CT) plays a crucial role in the rapid diagnosis and classification of stroke, enabling timely clinical management and improved patient outcomes.

Objective: To evaluate the computed tomography findings, stroke patterns, and clinical outcomes among acute stroke patients attending Federal Medical Centre (FMC), Katsina State, Nigeria.

Methods: A retrospective cross-sectional study was conducted using anonymized records of 200 acute stroke patients who underwent CT brain examinations at FMC Katsina between January 2025 and May 2026. Data extracted included age, sex, vascular risk factors, stroke subtype, CT findings, Glasgow Coma Scale (GCS) score, affected hemisphere, and clinical outcome. Descriptive statistics were used to summarize the data, and results were presented as frequencies, percentages, means, and standard deviations.

Results: A total of 200 patients were included in the study. The mean age was 57.0 ± 20.7 years, with males accounting for 60.0% of cases. Ischemic stroke was the predominant subtype, occurring in 75.5% of patients, while hemorrhagic stroke accounted for 24.5%. The most frequently observed CT findings included cerebral edema (19.0%), normal early CT appearances (19.0%), middle cerebral artery infarction (16.5%), intracerebral hemorrhage (16.0%), and lacunar infarction (16.0%). Hypertension was the most common vascular risk factor. The mean GCS score was 9.9 ± 3.0. Clinical outcomes showed that 66.5% of patients improved, 23.5% remained stable, and 10.0% died during management. No statistically significant association was found between stroke subtype and sex, hypertension, diabetes mellitus, smoking status, or clinical outcome (p > 0.05).