Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Nakajima, M. Articles by Minematsu, K. Search for Related Content PubMed PubMed Citation Articles by Nakajima, M. Articles by Minematsu, K.

American Journal of Neuroradiology 25:238-241, February 2004
© 2004 American Society of Neuroradiology

BRAIN

Relationships between Angiographic Findings and National Institutes of Health Stroke Scale Score in Cases of Hyperacute Carotid Ischemic Stroke

Makoto Nakajima^a, Kazumi Kimura^a, Toshiyasu Ogata^a, Tatsuro Takada^a, Makoto Uchino^b and Kazuo Minematsu^a

^a Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Kumamoto, Japan
^b Kumamoto University School of Medicine, Kumamoto, Japan

Address reprint requests to Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan

BACKGROUND AND PURPOSE: Stroke severity in cases of hyperacute carotid ischemic stroke may be related to site of arterial occlusion. We evaluated the relationships between National Institutes of Health Stroke Scale (NIHSS) scores and findings on intra-arterial digital subtraction angiograms (IA-DSA) of patients with ischemic stroke within 6 hr of stroke onset.

METHODS: A total of 43 consecutive patients (38 men and five women; mean age, 69.4 ± 8.7 years) with ischemic stroke in the carotid territory underwent IA-DSA within 6 hr of stroke onset. Baseline NIHSS score was assessed immediately before IA-DSA. Patients were divided into four groups according to site of arterial occlusion: 1) the internal carotid artery (ICA group, n = 10); 2) stem of the middle cerebral artery or stem of the anterior cerebral artery (Stem group, n = 14); 3) branches of middle cerebral artery or anterior cerebral artery (Branch group, n = 11); and 4) no arterial occlusion (Normal group, n = 8).

RESULTS: Mean (±SD) NIHSS score was 14.7 ± 7.4. The interval from stroke onset to IA-DSA study was 205 ± 76 min. NIHSS score was higher in the ICA group (median, 23; range, 6–32) than in the Branch (median, 17; range, 11–25; P = .02) or Normal (median, 15; range, 2–17; P < .001) groups but was not higher than in the Stem group (median, 6; range, 1–11; P = .73). Sensitivity-specificity curve analysis suggested an NIHSS score 10 as indicative of arterial occlusion of the carotid system. A total of 96.9% of patients with NIHSS scores 10 displayed arterial occlusion, and 63.6% of patients with NIHSS scores <10 displayed no arterial occlusion.

CONCLUSION: NIHSS score is related to site of arterial occlusion in cases of hyperacute carotid ischemic stroke. An NIHSS score of 10 seems to represent the cut-off for discriminating between patients with arterial occlusion and patients without.

This article has been cited by other articles:

				A. M. Brunser, P. M. Lavados, A. Hoppe, J. Lopez, M. Valenzuela, and R. Rivas Accuracy of Transcranial Doppler Compared With CT Angiography in Diagnosing Arterial Obstructions in Acute Ischemic Strokes Stroke, June 1, 2009; 40(6): 2037 - 2041. [Abstract] [Full Text] [PDF]

				H.J. Cloft, A. Rabinstein, G. Lanzino, and D.F. Kallmes Intra-Arterial Stroke Therapy: An Assessment of Demand and Available Work Force AJNR Am. J. Neuroradiol., March 1, 2009; 30(3): 453 - 458. [Abstract] [Full Text] [PDF]

				B. Nazliel, S. Starkman, D. S. Liebeskind, B. Ovbiagele, D. Kim, N. Sanossian, L. Ali, B. Buck, P. Villablanca, F. Vinuela, et al. A Brief Prehospital Stroke Severity Scale Identifies Ischemic Stroke Patients Harboring Persisting Large Arterial Occlusions Stroke, August 1, 2008; 39(8): 2264 - 2267. [Abstract] [Full Text] [PDF]

				S. Sato, K. Toyoda, T. Uehara, N. Toratani, C. Yokota, H. Moriwaki, H. Naritomi, and K. Minematsu Baseline NIH Stroke Scale Score predicting outcome in anterior and posterior circulation strokes Neurology, June 10, 2008; 70(24_Part_2): 2371 - 2377. [Abstract] [Full Text] [PDF]

				The IMS II Trial Investigators The Interventional Management of Stroke (IMS) II Study Stroke, July 1, 2007; 38(7): 2127 - 2135. [Abstract] [Full Text] [PDF]

				A. Ciccone, L. Valvassori, R. Gasparotti, F. Scomazzoni, E. Ballabio, and R. Sterzi Debunking 7 Myths That Hamper the Realization of Randomized Controlled Trials on Intra-Arterial Thrombolysis for Acute Ischemic Stroke Stroke, July 1, 2007; 38(7): 2191 - 2195. [Abstract] [Full Text] [PDF]

				C. M. Boyd, C. O. Weiss, J. Halter, K. C. Han, W. B. Ershler, and L. P. Fried Framework for Evaluating Disease Severity Measures in Older Adults With Comorbidity J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2007; 62(3): 286 - 295. [Abstract] [Full Text] [PDF]

				U. Fischer, M. Arnold, K. Nedeltchev, C. Brekenfeld, P. Ballinari, L. Remonda, G. Schroth, and H. P. Mattle NIHSS Score and Arteriographic Findings in Acute Ischemic Stroke Stroke, October 1, 2005; 36(10): 2121 - 2125. [Abstract] [Full Text] [PDF]