Differentiating Ischemic and Haemorrhagic Strokes Using Clinical Stroke Scores and Their Correlation with Imaging Studies
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 2
Abstract
Abstract: The study aimed to determine the accuracy of the stroke scores (Allen’s score, Siriraj score and Greek score) to differentiate between ischemic and haemorrhagic strokes. 100 patients of acute stroke that were admitted to Dr.D.Y.patil hospital, Kolhapur were included in the study. The patients were examined clinically and all the variables included in the three stroke scores were carefully evaluated before subjecting the patients to brain imaging. Out of 100 patients, 73 had cerebral ischemia and 27 had cerebral haemorrhage by brain imaging. Out of 73 patients with Ischemia Allen’s score diagnosed 58 patients, Siriraj score diagnosed 65 patients and Greek score diagnosed 49 patients correctly to have Ischemia. Out of 27 patients with Haemorrhage Allen’s score diagnosed 21 patients, Siriaj score diagnosed 22 patients and Greek score diagnosed 17 patients correctly to have cerebral haemorrhage. The overall sensitivity (%), specificity (%), positive predictive value (%) and negative predictive value (%) of Allen’s score for Ischemia is 79.4, 92.5, 96 and 62.5, Allen’s score for haemorrhage is 77.7, 95.8, 87.5 and 92 respectively. With Siriraj score for Ischemia it is 89, 96.2, 98.4 and 74.4, for haemorrhage it is 81.4, 97.2, 91.6 and 93.4 respectively. With Greek score for ischemia it is 67.1, 85.1, 92.4 and 48.9, and for haemorrhage it is 62.9, 97.2, 89.4 and 87.6 respectively. Siriraj score is better among all the three scores in terms of application and results. It is simpler and easier to calculate and time required to diagnose is less compared to Allen’s score, while Greek score is not a reliable score for diagnosis. Whenever a clinician wishes to start patient on antithrombotic measures while waiting for imaging results or when Imaging facilities are not available, Siriraj score is the single best score for diagnosis.
Authors and Affiliations
Anirudh Raghavendra, Shailendra Mane
Keywords
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