Abstract
Background and purposeThe National Institutes of Health Stroke Scale (NIHSS) has been found to be biased toward the left hemispheric and motoric functions providing minimal assessment to the right hemispheric language and cognitive functions. The need to complement the role of the NIHSS is necessary in accurate and rapid assessment of AIS patients and better management. We hypothesized that combining the NIHSS with a quantitative analysis of Spoken Picture Description scale of Comprehensive Aphasia Test (SPD-CAT) could provide valuable data regarding side, site, and size of stroke.Subjects and methodsEighty-six AIS patients presented within 48 h of onset of stroke were enrolled from Stroke Units of Ain-Shams University Hospitals (ASUHS). Clinical Assessment with NIHSS and SPD-CAT were correlated with the radiological MRI Brain lesions of stroke regarding (site, side, size/volume and lesion volume percent to the whole brain volume “LV% WBV”).ResultsTotal and subscale scores of NIHSS and SPD-CAT have a highly statistically significant correlation with the ischemic “LV% WBV.” Quantitative analysis (content units) of SPD-CAT may help in prediction of the lobar site of the stroke with higher significance in the tempro-parietal and brainstem regions. Right hemispheric strokes have clinically and statistically significant scores on SPD-CAT in comparison to NIHSS scores. Also, the left to right ratio of content units of information carrying words (ICWs) in SPD-CAT gives a significant difference between right and left hemispheric strokes. Recording and analysis time of SPD-CAT makes it easy and rapidly applicable in emergency room (ER) and stroke units.ConclusionCombining the quantitative analysis of NIHSS and SPD-CAT can better predict the side, size, and site of AIS within reasonable time table and without urgent MRI for AIS assessment and management.
Highlights
Cerebrovascular stroke is the second leading cause for both mortality and disability in Egypt [1]
There are radiological correlates, when quantifying extent of cerebral damage for a specified National Institutes of Health Stroke Scale (NIHSS) score; the median volume of righthemisphere strokes is larger than the volume of lefthemisphere strokes, suggesting non-dominant strokes are required to be more severe to reach the same grading on the NIHSS [7, 8]
Demographic data distribution of the study group Eighty-six patients enrolled with age range from 22 to 87 years with mean age (62.34 ± 12.01)
Summary
Cerebrovascular stroke is the second leading cause for both mortality and disability in Egypt [1]. The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a Zakieldine et al The Egyptian Journal of Neurology, Psychiatry and Neurosurgery (2020) 56:8 example, cranial nerve lesions [6]. An emerging trend to complement the role of the NIHSS score with another score primarily assessing the non-dominant hemispheric functions in the initial assessment of the stroke patient has been started in the world’s stroke institutes. This expansion of the NIHSS may be especially valuable in settings where imaging is not available or not possible, to better estimate lesion volume [9]. We hypothesized that combining the NIHSS with a quantitative analysis of Spoken Picture Description scale of Comprehensive Aphasia Test (SPD-CAT) could provide valuable data regarding side, site, and size of stroke
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
