The Scandinavian Neurological Stroke Scale (SSS) can be used to evaluate a patient who has had an acute ischemic stroke. The scale can predict both prognosis and long-term outcome. The score was developed by the Scandinavian Stroke Study Group.
Parameters:
(1) consciousness
(2) eye movements
(3) motor power in arm on the affected side
(4) motor power in hand on the affected side
(5) motor power in leg on the affected side
(6) orientation
(7) speech
(8) facial palsy
(9) gait
|
Parameter |
Finding |
Points |
|
consciousness |
fully conscious |
6 |
|
|
somnolent, can be awakened to full consciousness |
4 |
|
|
reacts to verbal command but not fully conscious |
2 |
|
|
unconscious |
0 |
|
eye movements |
no gaze palsy |
4 |
|
|
gaze palsy present |
2 |
|
|
conjugate eye deviation |
0 |
|
motor power in arm |
raises arm with normal strength |
6 |
|
|
raises arm with reduced strength |
5 |
|
|
raises arm with flexion in elbow |
4 |
|
|
can move, but not against gravity |
2 |
|
|
paralysis |
0 |
|
motor power in hand |
normal strength |
6 |
|
|
reduced strength in full range |
4 |
|
|
some movement; fingertips do not reach palm |
2 |
|
|
paralysis |
0 |
|
motor power in leg |
normal strength |
6 |
|
|
raises straight leg with reduced strength |
5 |
|
|
raises leg with flexion of knee |
4 |
|
|
can move, but not against gravity |
2 |
|
|
paralysis |
0 |
|
orientation |
correct for time, place and person |
6 |
|
|
2 out of time, place and person |
4 |
|
|
1 out of time, place and person |
2 |
|
|
completely disoriented |
0 |
|
speech |
no aphasia |
10 |
|
|
limited vocabulary |
6 |
|
|
incoherent speech |
6 |
|
|
more than yes/no but no longer sentences |
3 |
|
|
only yes/no |
0 |
|
|
less than yes/no |
0 |
|
facial palsy |
none |
2 |
|
|
dubious |
2 |
|
|
present |
0 |
|
gait |
walks 5 meters without aids |
12 |
|
|
walks with aids |
9 |
|
|
walks with help of another person |
6 |
|
|
sits without support |
3 |
|
|
bedridden or wheelchair bound |
0 |
where:
• The table in Lindestrom et al did not have an entry for unconsciousness. I added it because it seemed to make sense.
prognostic score =
= (points for consciousness) + (points for eye movement) + (points for motor power in arm) + (points for motor power in leg)
long term score =
= (points for motor power in arm) + (points for motor power in hand) + (points for motor power in leg) + (points for orientation) + (points for speech) + (points for facial palsy) + (points for gait)
Interpretation:
• minimum prognostic or long term score: 0
• maximum prognostic score: 22
• maximum long term score: 48
• The higher the scores the better the prognosis.
Performance:
• Interobserver agreement good to excellent (weighted kappa value 0.69 to 0.91).
• The score was found to be reliable for stratification of stroke patients and for evaluation of long-term outcome.
Specialty: Neurology
ICD-10: ,
