Can a clinical score aid in early diagnosis and treatment of various stroke syndromes?
BACKGROUND
Accurate and timely diagnosis of hemorrhagic and nonhemorrhagic strokes helps in patient management. Neuroimaging studies are useful in diagnosis and distinction of hemorrhagic (HS) and nonhemorrhagic (NHS) strokes. The use of clinical variables, such as Siriraj stroke scores (SSS), has shown good sensitivity, specificity and predictive values (distinguishing stroke types). The aim of our study was to evaluate the use of SSS in a U.S. population and assess whether it could aid to expedite treatment decisions.


METHODS
Levels of consciousness, vomiting, headache and atheroma markers used in SSS were applied to patients who met the criteria for stroke.


RESULTS
Of the 302 patients identified, the SSS classified 254 with sensitivity of 36% (HS) and 90% (NHS) and positive predictive values of 77% and 61%, respectively.


CONCLUSIONS
Our results suggest that SSS is not reliable in distinguishing stroke types (in a US population). Definite neuroimaging studies are needed prior to thrombolytic therapy.
Akpunonu
B E
BE
Department of Internal Medicine, Medical College of Ohio, Toledo 43699-0008, USA.
Mutgi
A B
AB
Lee
L
L
Khuder
S
S
Federman
D J
DJ
Roberts
C
C
D000368:Aged; D001161:Arteriosclerosis; D015415:Biomarkers; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000145:classification* / Q000175:diagnosis / Q000628:therapy; D003243:Consciousness; D005260:Female; D006261:Headache; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014839:Vomiting
D015415:Biomarkers