Efstathiou et al developed a simple tool for helping to distinguish between a hemorrhagic and ischemic stroke soon after presentation. The authors are from the Third University and Sotiria Hospital in Athens, Greece.
Patient selection: acute stroke
Parameters:
(1) neurological deterioration within 3 hours of admission
(2) vomiting
(3) decreased level of consciousness
(4) WBC count
Parameter
Finding
Points
neurological deterioration
no
0
yes
6
vomiting
no
0
yes
4
decreased level of consciousness
no
0
yes
3
WBC count
<= 12,000 per µL
0
> 12,000 per µL
4
total scor e=
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• A score <= 3 indicates ischemic stroke (infarct).
• A score >= 11 indicates intracerebral hemorrhage.
• A score from 4 to 10 is about 20% hemorrhagic and 80% ischemic.
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