The Copenhagen Stroke Scale is a rapid, valid and reliable scoring system for evaluating patients who have had a stroke. It can be used to assess the both the initial neurologic deficit and the subsequent course. The authors are from several hospitals in Copenhagen, Denmark.
Parameters:
(1) level of consciousness
(2) speech and comprehension (if right-sided hemiparesis)
(3) neglect (if left-sided hemiparesis)
(4) conjugate gaze deviation
(5) facial palsy
(6) visual field defect
(7) straight arm raising
(8) function of the hand
(9) straight leg raising
(10) gait
|
Parameter |
Finding |
Points |
|
level of consciousness |
completely lucid |
1 |
|
|
somnolent but can be verbally aroused and cooperates adequately |
2 |
|
|
difficult to awake; cooperates poorly |
3 |
|
|
cannot be awakened |
4 |
|
speech and comprehension |
normal speech and comprehension |
1 |
|
|
slightly abnormal speech and/or comprehension |
2 |
|
|
speaks and/or comprehends poorly |
3 |
|
|
speech unintelligible or absent and/or severe comprehension difficulty |
4 |
|
neglect |
no neglect |
1 |
|
|
probable neglect |
2 |
|
|
definite neglect; does not spontaneously mention the hemiparesis, is mentally flat and unconcerned. |
3 |
|
|
denial of hemiparesis (anosognosia) |
4 |
|
conjugate gaze deviation |
none |
1 |
|
|
probable |
2 |
|
|
definite (looks towards focus) |
3 |
|
|
marked, constant deviation with forced turning |
4 |
|
facial palsy |
none |
1 |
|
|
mild |
2 |
|
|
marked |
3 |
|
|
complete |
4 |
|
visual field defect |
none |
1 |
|
|
probable |
2 |
|
|
homonymous quadrant anopsia |
3 |
|
|
complete homonymous hemianopsia |
4 |
|
straight arm raising |
normal power |
1 |
|
|
against resistance but with reduced power |
2 |
|
|
against gravity, but not against resistance |
3 |
|
|
not possible |
4 |
|
function of the hand |
normal |
1 |
|
|
decreased fine finger movements |
2 |
|
|
marked paresis of finger extension and/or flexion |
3 |
|
|
no finger flexion or extension |
4 |
|
straight leg raising |
normal power |
1 |
|
|
against resistance but with reduced power |
2 |
|
|
against gravity, but not against resistance |
3 |
|
|
not possible |
4 |
|
gait |
normal |
1 |
|
|
with a device (cane, walker, etc.) |
2 |
|
|
with support of 1 or 2 persons |
3 |
|
|
not possible |
4 |
from Table 2, page 62
Instructions for scoring:
(1) If the level of consciousness is difficult to awake or cannot awaken, then score items 2 and 3 to have 4 points.
(2) Score speech and comprehension (item 2) only for patients with right-sided hemiparesis.
(3) Score neglect (item 3) only for patients with left-sided hemiparesis.
(4) If cooperation is poor, evaluate visual field defect (item 6) by hand movements in the suspected blind field. An absent blink reflex indicates a field defect.
stroke score =
= SUM(points for all of the applicable parameters)
Interpretation:
• minimum score: 10
• maximum score: 40 (if bilateral hemiparesis, with all 10 items), 36 (if unilateral, with 9 items), 32 (if no hemiparesis, with 8 items)
• The higher the score, the more severely the patient is affected.
percent of maximal score =
= ((total score) – (number of items)) / ((maximal score) – (number of items)) * 100%
Specialty: Neurology
ICD-10: ,
