Clinical diagnosis of ischemic versus hemorrhagic stroke: applicability of existing scores in the emergency situation and proposal of a new score.
Several scores exist to clinically differentiate between ischemic and hemorrhagic stroke, but none has been developed in the emergency situation in which transient ischemic attack (TIA) and cerebral infarction might not yet be clearly distinguished. Information on 540 patients with ischemia (including TIA) or hemorrhage was abstracted from medical charts. Of 540 patients hospitalized with stroke, 98 had a hemorrhage. Age, obesity, anamnestic stroke/TIA, peripheral arterial disease, onset during physical activity, headache, impaired consciousness, hemisyndrome, meningismus and systolic blood pressure contributed to the differential diagnosis and were included in our proposed score. The score performed well in comparison with existing scores. The inclusion of TIA and the explicit incorporation of incomplete information may enhance the applicability of differential diagnostic scores in the prehospital emergency situation.
Stürmer
Til
T
Department of Epidemiology, German Centre for Research on Ageing, Heidelberg, Germany. sturmer@dzfa.uni-heidelberg.de
Schlindwein
Gregor
G
Kleiser
Bernhard
B
Roempp
Achim
A
Brenner
Hermann
H
D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000145:classification / Q000175:diagnosis*; D002544:Cerebral Infarction / Q000145:classification / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004630:Emergencies; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis