CAN A CLINICAL SCORE AID IN EARLY DIAGNOSIS AND TREATMENT OF VARIOUS STROKE SYNDROMES

Background: Accurate and timely diagnosis of hemorrhagic and nonhemorr hagic strokes helps in patient management. Neuroimaging studies are us eful in diagnosis and distinction of hemorrhagic (HS) and nonhemorrhag ic (NHS) strokes. The use of clinical variables, such as Siriraj strok e scores (SSS), has shown good sensitivity, specificity and predictive values (distinguishing stroke types). The aim of our study was to eva luate the use of SSS in a U.S. population and assess whether it could aid to expedite treatment decisions. Methods: Levels of consciousness, vomiting, headache and atheroma markers used in SSS were applied to p atients who met the criteria for stroke. Results: Of the 302 patients identified, the SSS classified 254 with sensitivity of 36% (HS) and 90 % (NHS) and positive predictive values of 77% and 61%, respectively. C onclusion: Our results suggest that SSS is not reliable in distinguish ing stroke types (in a US population). Definite neuroimaging studies a re needed prior to thrombolytic therapy.