Comparison of Siriraj Stroke Score with Computerized Tomography in Establishing the Type of the Stroke among Pakistani Population

Muhammad A Siddiqui,Attiya Sabeen Rahman,Salma Razzaque,Jamal Ara,Qaiser Jamal,Aneela Altaf

doi:10.15197/ejgm.01347

Abstract

Computed Tomography (CT) Scan is an accurate and a routinely done imaging technique to diagnose and differentiate haemorrhagic and ischaemic stroke. Siriraj Stroke Score (SSS) is weighted clinical score and European recognized for clinical and bedside differentiation between ischemic and haemorrhagic stroke. This study aimed to establish the accuracy of SSS in the bedside diagnosis of cerebral haemorrhage in comparison with CT scan to avoid delay in treatment. Total 152 patients were included in the study. Out of which 39.5% were male. Overall, mean age was 59.28±11.91, 56.32 ±12.69 in haemorrhagic group and 62.32±10.28 in non-haemorrhagic group. Sensitivity, specificity, PPV, and NPV of SSS for haemorrhagic stroke was 71.4%, 81.3%, 79.7% and 73.5% respectively. Overall accuracy for haemorrhagic stroke was found to be 76.3%. SSS had higher sensitivity for haemorrhagic stroke and is more sensitive in Asian population, but still not accurate enough to replace CT scan as investigation of choice but can plays a role to avoid delay in the management where CT scan is delayed or not available.

Highlights

Cerebrovascular disease or stroke is the third most common cause of death after cancer and ischemic heart disease
Atheroma markers were present in 35.1%, absent in 64.9% in haemorrhagic group while these markers were present in 58.7%, and absent in 41.3% in non-haemorrhagic group (Table 2)
Clinical stroke scores like Siriraj score can be helpful in clinical differentiation between subtypes of stroke, where the facility of Computed Tomography (CT) brain is not available

Summary

Introduction

Cerebrovascular disease or stroke is the third most common cause of death after cancer and ischemic heart disease. The death rate following stroke is 25% [1]. Stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurological function. Stroke is uncommon below age of 40 years and is more common in males. In elderly, it remains a major cause of morbidity and mortality. The burden of the disease in South Asian countries (India, Pakistan, Bangladesh, and Sri Lanka) has inclined and is expected to rise [2]

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