The Finnish Prehospital Stroke Scale (FPSS) can help to differentiate large vessel occlusions (LVO) from strokes without LVO. This can be helpful in triaging patients in the prehospital setting. The authors are from Tampere University, Central Finland General Hospital and Tampere General Hospital.
Patient selection: prehospital evaluation of a possible stroke patient
Parameters:
(1) facial droop
(2) weakness of 1 or more extremities
(3) difficulty understanding or producing speech (slurring, etc)
(4) visual field cut or blindness
(5) partial or fixed gaze or head deviation away from the paretic side (conjugated eye deviation, CED)
|
Parameter
|
Finding
|
Points
|
|
facial droop
|
absent
|
0
|
|
|
present
|
1
|
|
weakness in extremities
|
none
|
0
|
|
|
>= 1 extremity
|
1
|
|
difficulty with speech
|
none
|
0
|
|
|
present
|
1
|
|
visual field defect or blindness
|
absent
|
0
|
|
|
present
|
1
|
|
partial/fixed gaze or head deviation away from paretic side
|
absent
|
0
|
|
|
present
|
4
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score from 1 to 4 indicates a non-large vessel occlusion.
• A score from 5 to 8 indicates a large vessel occlusion (LVO), typically in the first segment of the middle cerebral artery (M1).
Performance:
• Detection of LVO had a sensitivity of 54%, specificity 91% and negative predictive value of 93%.
• The interpretation of the score if the first 4 items are negative and the fifth present is uncertain.
