National Institutes of Health Stroke Scale Score and Vessel Occlusion in 2152 Patients With Acute Ischemic Stroke
National Institutes of Health Stroke Scale Score and Vessel Occlusion in 2152 Patients With Acute Ischemic Stroke
复制标题
DOI：
10.1161/strokeaha.111.000604
复制
发表时间：
2013-04-01
期刊：
影响因子：
8.3
通讯作者：
Fischer, Urs
中科院分区：
文献类型：
--
作者：
Heldner, Mirjam R.;Zubler, Christoph;Fischer, Urs
背景和目的：在急性脑卒中中，用美国国立卫生研究院卒中量表（NIHSS）评分预测MR动脉造影和CT动脉造影的动脉闭塞存在一些争议（35.4%的女性，平均年龄66 +/- 14岁）与急性前或后循环stroks.Results-The研究包括1603例患者与MR动脉造影和CT动脉造影549。其中，1043例患者（48.5%;中位NIHSS评分5，至临床评估的中位时间179分钟）显示闭塞，887例在前循环（中位NIHSS评分7/0-31），156例在后循环（中位NIHSS评分3/0-32）。860个可视化闭塞（82.5%）位于中心（即，基底动脉、颅内椎动脉、颈内动脉或大脑中动脉的M1/M2段）。NIHSS评分可预测前循环中的任何血管闭塞。症状发作后3小时内的最佳临界值为NIHSS评分>= 9（阳性预测值86.4%）和>3至6小时内NIHSS评分>= 7（阳性预测值84.4%）。3小时内出现中央闭塞的患者的NIHSS评分
Background and Purpose-There is some controversy on the association of the National Institutes of Health Stroke Scale (NIHSS) score to predict arterial occlusion on MR arteriography and CT arteriography in acute stroke.Methods-We analyzed NIHSS scores and arteriographic findings in 2152 patients (35.4% women, mean age 66 +/- 14 years) with acute anterior or posterior circulation strokes.Results-The study included 1603 patients examined with MR arteriography and 549 with CT arteriography. Of those, 1043 patients (48.5%; median NIHSS score 5, median time to clinical assessment 179 minutes) showed an occlusion, 887 in the anterior (median NIHSS score 7/0-31), and 156 in the posterior circulation (median NIHSS score 3/0-32). Eight hundred sixty visualized occlusions (82.5%) were located centrally (ie, in the basilar, intracranial vertebral, internal carotid artery, or M1/M2 segment of the middle cerebral artery). NIHSS scores turned out to be predictive for any vessel occlusions in the anterior circulation. Best cut-off values within 3 hours after symptom onset were NIHSS scores >= 9 (positive predictive value 86.4%) and NIHSS scores >= 7 within >3 to 6 hours (positive predictive value 84.4%). Patients with central occlusions presenting within 3 hours had NIHSS scores