Purrucker et al shortened the original National Institute of Health Stroke Scale so that it can be used by Emergency Medical Services. This can aid in prehospital stroke triage. The authors are from University of Heidelberg, Tuebingen University and University of Stuttgart.
Patient: possible stroke patient in the community (prehospital)
Parameters:
(1A) loss of consciousness
(4) facial palsy
(5a) motor left arm
(5b) motor right arm
(6a) motor left leg
(6b) motor right leg
(8) sensory
(9) language
(10) dysarthria
|
Parameter |
Finding |
Points |
|
level of consciousness (LOC; 1A) |
alert |
0 |
|
|
obtunded |
2 |
|
|
coma |
3 |
|
facial palsy (4) |
normal |
0 |
|
|
minor |
1 |
|
|
partial |
2 |
|
|
complete |
3 |
|
motor arm, left (5) |
no drift |
0 |
|
|
drift before 10 seconds |
1 |
|
|
falls before 10 seconds |
2 |
|
|
no effort against gravity |
3 |
|
|
no movement |
4 |
|
motor arm, right (5) |
no drift |
0 |
|
|
drift before 10 seconds |
1 |
|
|
falls before 10 seconds |
2 |
|
|
no effort against gravity |
3 |
|
|
no movement |
4 |
|
motor leg, left (6) |
no drift |
0 |
|
|
drift before 10 seconds |
1 |
|
|
falls before 10 seconds |
2 |
|
|
no effort against gravity |
3 |
|
|
no movement |
4 |
|
motor leg, right (6) |
no drift |
0 |
|
|
drift before 10 seconds |
1 |
|
|
falls before 10 seconds |
2 |
|
|
no effort against gravity |
3 |
|
|
no movement |
4 |
|
sensory (8) |
normal |
0 |
|
|
partial loss |
1 |
|
|
severe loss |
2 |
|
language (9) |
no aphasia |
0 |
|
|
mild to moderate aphasia |
1 |
|
|
severe aphasia |
2 |
|
|
mute or global aphasia |
3 |
|
dysarthria (10) |
normal articulation |
0 |
|
|
mild to moderate dysarthria |
1 |
|
|
severe dysarthria |
2 |
where:
• Motor performance is graded with the extremity outstretched based on the ability to resist gravity is timed for 10 seconds.
clinical stroke scale score =
= SUM(parameter points)
Interpretation:
• minimum score: 0
• maximum score: 29
• The higher the score, the more severe the infarct and the worse prognosis.
• A score >= 6 had the highest Youden index (sensitivity 70.3%, specificity 80.7%)
Specialty: Neurology
