Mathew et al described a scale for the neurological evaluation of a patient with acute stroke. The score correlates well with the severity of the stroke and changes in the score parallel changes in the patient's neurological and general clinical status. It was developed at Baylor-Methodist Center for Cerebrovascular Research in Houston, Texas.
Factors examined during the neurological examination:
(1) level of consciousness (mentation)
(2) orientation (mentation)
(3) speech
(4) homonymous hemianopsia (cranial nerves)
(5) conjugate deviation of the eyes (cranial nerves)
(6) facial weakness (cranial nerves)
(7) motor power, left arm
(8) motor power, right arm
(9) motor power, left leg
(10) motor power, right leg
(11) performance or disability status scale
(12) reflexes
(13) sensation
|
Factor |
Finding |
Points |
|---|---|---|
|
level of consciousness |
fully conscious |
8 |
|
|
lethargic but mentally intact |
6 |
|
|
obtunded |
4 |
|
|
stuporous |
2 |
|
|
comatose |
0 |
|
orientation |
oriented to person, time and place |
6 |
|
|
oriented x2 |
4 |
|
|
oriented x1 |
2 |
|
|
disoriented |
0 |
|
speech |
Reitan test |
0 - 23 |
|
homonymous hemianopsia |
intact |
3 |
|
|
mild |
2 |
|
|
moderate |
1 |
|
|
severe |
0 |
|
conjugate deviation of eyes |
intact |
3 |
|
|
mild |
2 |
|
|
moderate |
1 |
|
|
severe |
0 |
|
facial weakness |
intact |
3 |
|
|
mild |
2 |
|
|
moderate |
1 |
|
|
severe |
0 |
|
motor power, left arm |
normal strength |
5 |
|
|
contracts against resistance |
4 |
|
|
elevates against gravity |
3 |
|
|
gravity eliminated |
2 |
|
|
flicker |
1 |
|
|
no movement |
0 |
|
motor power, right arm |
normal strength |
5 |
|
|
contracts against resistance |
4 |
|
|
elevates against gravity |
3 |
|
|
gravity eliminated |
2 |
|
|
flicker |
1 |
|
|
no movement |
0 |
|
motor power, left leg |
normal strength |
5 |
|
|
contracts against resistance |
4 |
|
|
elevates against gravity |
3 |
|
|
gravity eliminated |
2 |
|
|
flicker |
1 |
|
|
no movement |
0 |
|
motor power, right leg |
normal strength |
5 |
|
|
contracts against resistance |
4 |
|
|
elevates against gravity |
3 |
|
|
gravity eliminated |
2 |
|
|
flicker |
1 |
|
|
no movement |
0 |
|
performance or disability status scale |
normal |
28 |
|
|
mild impairment |
21 |
|
|
moderate impairment |
14 |
|
|
severe impairment |
7 |
|
|
death |
0 |
|
reflexes |
normal |
3 |
|
|
asymmetrical reflexes |
2 |
|
|
pathological reflexes |
2 |
|
|
clonus |
1 |
|
|
no reflexes elicited |
0 |
|
sensations |
normal |
3 |
|
|
mild sensory abnormality |
2 |
|
|
severe sensory abnormality |
1 |
|
|
no response to pain |
0 |
where:
• Reitan test = a series of tests that evaluate speech function and which are independent of a person's educational and socio-economic status
• homonymous hemianopsia = hemianopia affecting the right halves or the left halves of the visual fields in both eyes
stroke score =
= SUM(points for all 13 parameter)
Interpretation:
• minimum score: 0, indicating death
• maximum score: 100, indicating no sequelae.
• The higher the score, the less severe the impairment due to the stroke.
Specialty: Neurology
ICD-10: ,
