e-NIHSS: an Expanded National Institutes of Health Stroke Scale Weighted for Anterior and Posterior Circulation Strokes

Background The National Institutes of Health Stroke Scale (NIHSS) is the most widespread clinical scale used in patients presenting with acute stroke. The merits of the NIHSS include simplicity, quickness, and agreement between clinicians. The clinical evaluation on posterior circulation stroke rema...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2016-12, Vol.25 (12), p.2953-2957
Main Authors: Olivato, Silvia, MD, Nizzoli, Silvia, MD, Cavazzuti, Milena, MD, Casoni, Federica, MD, Nichelli, Paolo Frigio, MD, Zini, Andrea, MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cardiovascular
Cerebrovascular Circulation
Disability Evaluation
Female
Health Status
Humans
Infarction, Anterior Cerebral Artery - diagnosis
Infarction, Anterior Cerebral Artery - physiopathology
Infarction, Anterior Cerebral Artery - psychology
Infarction, Posterior Cerebral Artery - diagnosis
Infarction, Posterior Cerebral Artery - physiopathology
Infarction, Posterior Cerebral Artery - psychology
Male
Middle Aged
Neurologic Examination
Neurology
Neuropsychological Tests
Observer Variation
posterior circulation infarct (POCI)
Predictive Value of Tests
Prognosis
Reproducibility of Results
Severity of Illness Index
stroke care
Stroke management
stroke scale
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Summary:Background The National Institutes of Health Stroke Scale (NIHSS) is the most widespread clinical scale used in patients presenting with acute stroke. The merits of the NIHSS include simplicity, quickness, and agreement between clinicians. The clinical evaluation on posterior circulation stroke remains still a limit of NIHSS. Methods We assessed the application of a new version of NIHSS, the e-NIHSS (expanded NIHSS), adding specific elements in existing items to explore signs/symptoms of a posterior circulation stroke. A total of 22 consecutive patients with suspected vertebrobasilar stroke were compared with 25 patients with anterior circulation stroke using NIHSS and e-NIHSS. Results We compared the NIHSS and e-NIHSS scores obtained by the 2 examiners, in patients with posterior circulation infarct (POCI), using the Wilcoxon test. Patients with POCI evaluated with e-NIHSS had an average of 2 points higher than patients evaluated with classical NIHSS. The difference was statistically significant ( P  
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2016.08.011