title: Historic Stroke Motor Severity Score Predicts Progression in TIA/Minor Stroke.
abstract: BACKGROUND
  transient ischemic attack (tIA) and minor stroke have a high risk of early neurological deterioration, and patients who experience early improvement are at risk of deterioration. We generated a score for quantifying the worst reported motor and speech deficits and assessed whether this predicted outcome.
  
  
  METHODS
  510 tIA or minor stroke (NIHSS>4) patients were included. the Historical Stroke Severity Score (HSSS) prospectively quantified the patient's description of the worst motor or speech deficits. the HSSS was rated at the time of first assessment with more severe deficits scoring higher. Motor HSSS included assessments of arm and leg motor power (score total 0-5). Speech HSSS assessed severity of dysarthria and aphasia (total 0-3). the association between motor and speech HSSS and symptom progression was assessed during the 90-day follow-up period.
  
  
  RESULTS
  the proportion of patients in each category of the motor HSSS was 0: 43% (216/510), 1: 22%(110/510), 2: 17% (89/510), 3: 7% (37/510), 4: 5% (28/510) and 5: 6% (30/510). Motor HSSS was associated with symptom progression (p=0.004) but not recurrent stroke. Speech HSSS was not associated with either progression or recurrent stroke. Motor HSSS predicted disability (p=0.002) and intracranial occlusion (p=0.012). Disability increased with increasing motor HSSS.
  
  
  CONCLUSIONS
  taking a detailed history about the severity of motor deficits, but not speech, predicted outcome in tIA and minor stroke patients. A score based on the patient's description of the severity of motor symptoms predicted symptom progression, intracranial occlusion and functional outcome, but not recurrent stroke in a tIA and minor stroke population.
  
  
  
  Le Historical Stroke Severity Score moteur prédit la progression d'un accès ischémique cérébral transitoire / d'un accident vasculaire cérébral mineur.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Camden
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
authors.forename: Alexandre Y
authors.initials: AY
authors.lastname: Poppe
authors.forename: Nan
authors.initials: N
authors.lastname: Shobha
authors.forename: Philip A
authors.initials: PA
authors.lastname: Barber
authors.forename: Shelagh B
authors.initials: SB
authors.lastname: Coutts
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis*