The Toronto Stroke Scale can be used to evaluate a patient with acute stroke. It was developed at the University of Toronto in Canada.
Parameters:
(1) consciousness
(2) paresis face
(3) paresis arm
(4) paresis leg
(5) sensory loss face
(6) sensory loss arm
(7) sensory loss leg
(8) hemianopia
(9) aphasia
(10) higher cortical function, frontal
(11) higher cortical function, parietal
(12) dementia
(13) forced gaze
(14) incoordination
(15) dysarthria
(16) dysphagia
|
Parameter |
Finding |
Points |
Factor |
Value |
|---|---|---|---|---|
|
consciousness |
alert |
0 |
25 |
0 |
|
|
drowsy |
1 |
25 |
25 |
|
|
stupor |
2 |
25 |
50 |
|
|
light coma |
3 |
25 |
75 |
|
|
deep coma |
4 |
25 |
100 |
|
paresis, face |
none |
0 |
1 |
0 |
|
|
mild |
1 |
1 |
1 |
|
|
moderate |
2 |
1 |
2 |
|
|
severe |
3 |
1 |
3 |
|
pareses, arm |
none |
0 |
3.5 |
0 |
|
|
mild |
1 |
3.5 |
3.5 |
|
|
moderate |
2 |
3.5 |
7 |
|
|
severe |
3 |
3.5 |
10.5 |
|
|
total |
4 |
2.5 |
14 |
|
paresis, leg |
none |
0 |
2.5 |
0 |
|
|
mild |
1 |
2.5 |
2.5 |
|
|
moderate |
2 |
2.5 |
5 |
|
|
severe |
3 |
2.5 |
7.5 |
|
|
total |
4 |
2.5 |
10 |
|
sensory loss, face |
none |
0 |
1.5 |
0 |
|
|
mild-to-moderate |
1 |
1.5 |
1.5 |
|
|
moderate-to-severe |
2 |
1.5 |
3.0 |
|
sensory loss, arm |
none |
0 |
6 |
0 |
|
|
mild-to-moderate |
1 |
6 |
6 |
|
|
moderate-to-severe |
2 |
6 |
12 |
|
sensory loss, leg |
none |
0 |
4.5 |
0 |
|
|
mild-to-moderate |
1 |
4.5 |
4.5 |
|
|
moderate-to-severe |
2 |
4.5 |
9 |
|
hemianopia |
none |
0 |
3 |
0 |
|
|
mild-to-moderate |
1 |
3 |
3 |
|
|
moderate-to-severe |
2 |
3 |
6 |
|
aphasia |
none |
0 |
10 |
0 |
|
|
mild |
1 |
10 |
10 |
|
|
moderate |
2 |
10 |
20 |
|
|
severe |
3 |
10 |
30 |
|
|
total |
4 |
10 |
40 |
|
higher cortical function, frontal |
normal |
0 |
12 |
0 |
|
|
mild loss |
1 |
12 |
12 |
|
|
moderate to severe loss |
2 |
12 |
24 |
|
higher cortical function, parietal |
normal |
0 |
12 |
0 |
|
|
mild loss |
1 |
12 |
12 |
|
|
moderate to severe loss |
2 |
12 |
24 |
|
dementia |
none |
0 |
3 |
0 |
|
|
mild |
1 |
3 |
3 |
|
|
moderate |
2 |
3 |
6 |
|
|
severe |
3 |
3 |
9 |
|
forced gaze |
none |
0 |
2 |
0 |
|
|
mild |
1 |
2 |
2 |
|
|
moderate to severe |
2 |
2 |
4 |
|
incoordination |
none |
0 |
3 |
0 |
|
|
mild |
1 |
3 |
3 |
|
|
moderate |
2 |
3 |
6 |
|
|
severe |
3 |
3 |
9 |
|
dysarthria |
none |
0 |
2 |
0 |
|
|
mild |
1 |
2 |
2 |
|
|
moderate |
2 |
2 |
4 |
|
|
severe |
3 |
2 |
6 |
|
dysphagia |
none |
0 |
4 |
0 |
|
|
mild to moderate |
1 |
4 |
4 |
|
|
moderate to severe |
2 |
4 |
8 |
where:
• value = (points) * (factor)
Toronto stroke score =
= SUM(points for all 16 parameters)
Interpretation:
• minimum score: 0
• maximum score: 281
• According to the Figure on page 528, mild strokes have a score <30, moderate from 30 to 90, and severe > 90.
|
Toronto Stroke Scale (mean and range) |
Stroke Severity (Clinical Bedside Assessment) |
|---|---|
|
24 (1 – 50) |
mild |
|
72 (11 – 102) |
moderate |
|
114 (75 – 155) |
severe |
Specialty: Neurology
ICD-10: ,
