A simple 3 item scale can be used to predict the likelihood of stroke recovery shortly after admission to the hospital. This can help identify patients who may benefit from more aggressive therapy. The authors are from the National Institute of Neurological Disorders and Stroke (NINDS) and 8 other institutions in the USA, Canada, Australia and New Zealand.
Parameters:
(1) volume in mL for the site of ischemic brain injury in magnetic resonance diffuse-weighted imaging (MR DWI)
(2) National Institutes of Health Stroke Scale (NIHSS) score
(3) time in hours since onset
Parameter
Finding
Points
volume of lesion on MR DWI
<= 14.1 mL
1
> 14.1 mL
0
NIHSS score
<= 3
4
4 – 15
2
> 15
0
time in hours from onset
<= 3 hours
0
> 3 to 6 hours
1
> 6 hours
2
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score, the better the prognosis.
Score
Probability of Stroke Recovery
0 – 2
low
3 – 4
medium
5, 6 or 7
high
Performance:
• The sensitivity is 77%; specificity 88%.
Limitations:
• The score was validated in patients with strokes in the anterior circulation.
• The following patients were excluded: strokes in posterior circulation, multiple strokes, hemorrhagic strokes and TIAs.
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