Stroke, Vol 25, 362-365, Copyright © 1994 by American Heart Association
RJ Wityk, MS Pessin, RF Kaplan and LR Caplan
BACKGROUND AND PURPOSE: The National Institutes of Health (NIH) Stroke
Scale has been used in clinical trials to assess neurological outcome after
investigational therapy for acute stroke. We used the NIH Stroke Scale to
study the degree and time course of recovery in patients with acute stroke
who were treated with conventional therapy. METHODS: We serially assessed
50 patients with ischemic stroke who presented within 24 hours of onset of
symptoms. Patients were grouped by stroke subtype. Major neurological
improvement was defined as a decrease in the stroke score by 4 points or
more. RESULTS: The mean NIH stroke score for all patients improved
significantly by 7 to 10 days and at last follow-up (average, 44 days).
Major neurological improvement was seen in 5 of 41 patients (12%; 95%
confidence interval [CI], 2% to 22%) by 24 hours, 11 of 40 patients (28%;
95% CI, 14% to 41%) by 48 hours, and 19 of 37 patients (51%; 95% CI, 35% to
67%) by follow-up. The subgroup of patients with middle cerebral artery
territory embolism showed a similar pattern of improvement; in contrast,
patients with lacunar infarcts did not show significant change in scores
during the study period. The score on admission did not correlate with the
degree of subsequent improvement or deterioration. CONCLUSIONS: A
significant percentage of patients with acute ischemic stroke treated with
conventional therapy show early improvement as assessed by the NIH Stroke
Scale. The degree and time course of recovery may be influenced by stroke
type.
ARTICLES
Serial assessment of acute stroke using the NIH Stroke Scale [published erratum appears in Stroke 1994 Jun;25(6):1300]
Department of Neurology (Stroke Service), New England Medical Center, Boston, Mass.
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