Wednesday, April 23, 2014

Stroke/TIA: Scales & Recommendations

Rosier Scale:   Diagnoses Stroke
NIHSS:             Rates Severity of a stroke
ABCD2:           Predicts Stroke in TIA

Rosier Scale:

Negative Symptoms:
LOC/Syncope      -1
Seizures                 -1

Positive Symptoms: (FALSE Memonic)
Assymetric Weakness of Face     1
                                            Arms    1
                                            Legs     1
Disturbance in Speech                 1
                           Eyes (Vision)      1

Total Score -2 to 5
Score of > 0 is Stroke in absence of Hypoglycemia with a Sensitivity of 93% and Specificity of 83%

ABCD2 for TIA:

Age > 60                        1 point
BP   > 140/90                1 point
C/f
Unilateral Weakness   2 points
Slurred Speech only (no weakness)  1 point
Duration
> 60 minutes                      2 points
>10 minutes and < 60 minutes 1 point
<10 0="" minutes="" nbsp="" p="" points="">DM

Score: 0 to 7
< 4                   Aspirin and Secondary prevention
                        Imaging or Brain and carotids and consultation in 1 week

> 4                  Aspirin and Secondary prevention
                        Imaging or Brain and carotids and consultation in 24 hours

C/I to Thrombolysis in Stroke:

Age: <18 or="">80
BP: >185/110 or bleeding disorders
CNS: Neoplasm, AVM, Past Bleed, Recent Stroke
Duration: > 4.5 Hours
NIHSS: <5 or="">25
(Victoria Stacey 2012)

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