BACKGROUND AND PURPOSE: The purpose of the study was to design a simple stroke scale that requires minimal training but reflects initial stroke severity and is predictive of middle cerebral artery (MCA) occlusion. METHODS: The new stroke scale assessed 3 parameters: (1) level of consciousness, (2) gaze, and (3) motor function. Each item was graded 0 to 2, where 0 indicated normal findings and 2 severe abnormalities (ie, profound drowsiness or worse, forced gaze deviation, and severe hemiparesis, respectively). During a study period of 11 months, patients presenting with acute stroke symptoms (onset < or =6 hours) were examined by a stroke neurologist assessing the new scale as well as the National Institutes of Health Stroke Scale (NIHSS). In addition, 83 patients received acute magnetic resonance angiography (MRA; as part of an acute stroke protocol). RESULTS: The new stroke scale was strongly associated with the NIHSS. Interobserver reliability of the new scale was high (intraclass correlation coefficient 0.947). Using post hoc analysis, a score of > or =4 predicted proximal vessel occlusion (T-segment or M1-segment occlusion of the MCA on MRA) almost as accurately (overall accuracy 0.86) as an NIHSS score of >or =14 (overall accuracy 0.93). CONCLUSIONS: The new stroke scale reflects acute stroke severity well and predicts proximal MCA occlusion with reasonable accuracy. However, the clinical scale needs further evaluation before it can be recommended as a tool for the triage of acute stroke patients.
BACKGROUND AND PURPOSE: The purpose of the study was to design a simple stroke scale that requires minimal training but reflects initial stroke severity and is predictive of middle cerebral artery (MCA) occlusion. METHODS: The new stroke scale assessed 3 parameters: (1) level of consciousness, (2) gaze, and (3) motor function. Each item was graded 0 to 2, where 0 indicated normal findings and 2 severe abnormalities (ie, profound drowsiness or worse, forced gaze deviation, and severe hemiparesis, respectively). During a study period of 11 months, patients presenting with acute stroke symptoms (onset < or =6 hours) were examined by a stroke neurologist assessing the new scale as well as the National Institutes of Health Stroke Scale (NIHSS). In addition, 83 patients received acute magnetic resonance angiography (MRA; as part of an acute stroke protocol). RESULTS: The new stroke scale was strongly associated with the NIHSS. Interobserver reliability of the new scale was high (intraclass correlation coefficient 0.947). Using post hoc analysis, a score of > or =4 predicted proximal vessel occlusion (T-segment or M1-segment occlusion of the MCA on MRA) almost as accurately (overall accuracy 0.86) as an NIHSS score of >or =14 (overall accuracy 0.93). CONCLUSIONS: The new stroke scale reflects acute stroke severity well and predicts proximal MCA occlusion with reasonable accuracy. However, the clinical scale needs further evaluation before it can be recommended as a tool for the triage of acute strokepatients.
Authors: Christian Haverkamp; Thomas Ganslandt; Petar Horki; Martin Boeker; Arnd Dörfler; Stefan Schwab; Joachim Berkefeld; Waltraud Pfeilschifter; Wolf-Dirk Niesen; Karl Egger; Manfred Kaps; Marc A Brockmann; Eva Neumaier-Probst; Kristina Szabo; Martin Skalej; Siegfried Bien; Christoph Best; Hans-Ulrich Prokosch; Horst Urbach Journal: Clin Neuroradiol Date: 2018-01-08 Impact factor: 3.649
Authors: Joey D English; Dileep R Yavagal; Rishi Gupta; Vallabh Janardhan; Osama O Zaidat; Andrew R Xavier; Raul G Nogueira; Jawad F Kirmani; Tudor G Jovin Journal: Interv Neurol Date: 2016-02-19
Authors: Brian S Katz; Opeolu Adeoye; Heidi Sucharew; Joseph P Broderick; Jason McMullan; Pooja Khatri; Michael Widener; Kathleen S Alwell; Charles J Moomaw; Brett M Kissela; Matthew L Flaherty; Daniel Woo; Simona Ferioli; Jason Mackey; Sharyl Martini; Felipe De Los Rios la Rosa; Dawn O Kleindorfer Journal: Stroke Date: 2017-07-12 Impact factor: 7.914
Authors: Jens Fiehler; Christophe Cognard; Mauro Gallitelli; Olav Jansen; Adam Kobayashi; Heinrich P Mattle; Keith W Muir; Mikael Mazighi; Karl Schaller; Peter D Schellinger Journal: Eur Stroke J Date: 2016-07-26
Authors: Y Mayasi; R P Goddeau; M Moonis; B Silver; A H Jun-O'Connell; A S Puri; N Henninger Journal: AJNR Am J Neuroradiol Date: 2017-11-23 Impact factor: 3.825
Authors: Branko N Huisa; William P Neil; Ronald Schrader; Marcel Maya; Benedict Pereira; Nhu T Bruce; Patrick D Lyden Journal: J Stroke Cerebrovasc Dis Date: 2012-12-14 Impact factor: 2.136