论文部分内容阅读
Background and Purpose -To test the hypothesis that the National Institutes of Health Stroke Scale (NIHSS) score is associated with the findings of arteriography performed within the first hours after ischemic stroke. Methods -We analyzed NIHSS scores on hospital admission and clinical and arteriographic findings of 226 consecutive patients (94 women, 132 men; mean age 62±12 years) who underwent arteriography within 6 hours of symptom onset in carotid stroke and within 12 hours in vertebrobasilar stroke. Results -From stroke onset to hospital admissi on, 155±97 minutes elapsed, and from stroke onset to arteriography 245±100 min utes elapsed. Median NIHSS was 14 (range 3 to 38), and scores differed depending on the arteriographie findings (P < 0.001). NIHSS scores in basilar, internal c arotid, and middle cerebral artery M1 and M2 segment occlusions (central occlusi ons) were higher than in more peripherally located, nonvisible, or absent occlus ions. Patients with NIHSS scores ≥10 had positive predictive values (PPVs) to s how arterial occlusions in 97%of carotid and 96%of vertebrobasilar strokes. Wi th an NIHSS score of ≥12, PPV to find a central occlusion was 91%. In a multiv ariate analysis, NIHSS subitems such as “level of consciousness questions,”“g aze,”“motor leg,”and “neglect”were predictors of central occlusions. Conclu sions -There is a significant association of NIHSS scores and the presence and location of a vessel occlusion. With an NIHSS score ≥10, a vessel occlusion wil l likely be seen on arteriography, and with a score ≥12, its location will prob ably be central.
Background and Purpose -To test the hypothesis that the National Institutes of Health Stroke Scale (NIHSS) score is associated with the findings of arteriography performed within the first hours after ischemic stroke. Methods -We analyzed NIHSS scores on hospital admission and clinical and arteriographic findings of-226 consecutive patients (94 women, 132 men; mean age 62 ± 12 years) who underwent arteriography within 6 hours of symptom onset in carotid stroke and within 12 hours in vertebrobasilar stroke. Results-Flow stroke onset to hospital admissi on, 155 ± 97 min elapsed, and from stroke onset to arteriography 245 ± 100 min utes elapsed. Median NIHSS was 14 (range 3 to 38), and scores differed depending on the arteriographie findings (P <0.001). NIHSS scores in basilar, internal c arotid , and middle cerebral artery M1 and M2 segment occlusions (central occlusi ons) were higher than in more peripherally located, nonvisible, or absent occlusions. Patients with NIHSS scores ≥10 had positive predictive values (PPVs) to s how arterial occlusions in 97% of carotid and 96% of vertebrobasilar strokes. Wi th an NIHSS score of> 12, PPV to find a central occlusion was 91%. In a multivariate analysis, NIHSS subitems such as “level of consciousness questions,” “g aze,” “motor leg,” and “neglect” were predictors of central occlusions. Conclu sions -There is a significant association of NIHSS scores and the presence and location of a vessel occlusion With an NIHSS score ≥10, a vessel occlusion wil l likely be seen on arteriography, and with a score ≥12, its location will prob ably be central.