A Clinical Stroke Scale based on the clinical examination can be used to assess patients following an acute cerebral infarction.
|
Parameter |
Finding |
Points |
|---|---|---|
|
level of consciousness (LOC) |
alert |
0 |
|
|
drowsy |
1 |
|
|
stuporous |
2 |
|
|
coma |
3 |
|
LOC questions |
answers both correctly |
0 |
|
|
answers one correctly |
1 |
|
|
incorrect for both questions |
2 |
|
LOC commands |
obeys both correctly |
0 |
|
|
obeys one correctly |
1 |
|
|
incorrect for both commands |
2 |
|
pupillary response |
both reactive |
0 |
|
|
one reactive |
1 |
|
|
neither reactive |
2 |
|
best gaze |
normal |
0 |
|
|
partial gaze palsy |
1 |
|
|
forced deviation |
2 |
|
best visual |
no visual loss |
0 |
|
|
partial hemianopia |
1 |
|
|
complete hemianopia |
2 |
|
facial palsy |
normal |
0 |
|
|
minor |
1 |
|
|
partial |
2 |
|
|
complete |
3 |
|
best motor arm |
no drift |
0 |
|
|
drift |
1 |
|
|
cannot resist gravity |
2 |
|
|
no effort against gravity |
3 |
|
best motor leg |
no drift |
0 |
|
|
drift |
1 |
|
|
cannot resist gravity |
2 |
|
|
no effort against gravity |
3 |
|
plantar reflex |
normal |
0 |
|
|
equivocal |
1 |
|
|
extensor |
2 |
|
|
bilateral extensor |
3 |
|
limb ataxia |
absent |
0 |
|
|
present in upper or lower |
1 |
|
|
present in both upper and lower |
2 |
|
sensory |
normal |
0 |
|
|
partial loss |
1 |
|
|
dense loss |
2 |
|
neglect |
none |
0 |
|
|
partial neglect |
1 |
|
|
complete neglect |
2 |
|
dysarthria |
normal articulation |
0 |
|
|
mild to moderate dysarthria |
1 |
|
|
near unintelligible or worse |
2 |
|
best language |
no aphasia |
0 |
|
|
mild to moderate aphasia |
1 |
|
|
severe aphasia |
2 |
|
|
mute |
3 |
|
change from previous exam |
same |
S |
|
|
better |
B |
|
|
worse |
W |
|
change from baseline |
same |
S |
|
|
better |
B |
|
|
worse |
W |
where:
• Motor performance is graded with the extremity outstretched; the ability to resist gravity is timed for 10 seconds
• Complete definitions for the parameters are available from the authors (Department of Neurology, University of Cincinnati Medical Center, 231 Bethesda Avenue, Cincinnati, Ohio 45267-0525).
clinical stroke scale score =
= SUM(parameter points)
Interpretation:
• minimum score: 0
• maximum score: 36
• The higher the score, the more severe the infarct and the worse prognosis.
• There are 9 combinations for the clinical status changes (S S, S B, S W, etc.)
Specialty: Neurology
ICD-10: ,
