Accuracy of clinical scores in differentiatingstroke subtypes in Mosul

Abstract

ABSTRACT
Objectives: To study the validity of clinical scores in differentiating intracerebral hemorrhage and ischemic stroke and to see which of them is more applicable in our hospitals.
Methods: A prospective study of 100 consecutive patients with acute neurological deficit admitted as inpatient to the neurological unit in Ibn-Sina Teaching Hospital in the city of Mosul, evaluated with computed tomography and Allen and Siriraj scores to determine the pathological type of stroke during the period from September 15th 2008 and January 28th 2009.
Results: The prevalence of hemorrhage (diagnosed with computed tomography) was 19%. Allen scores were "uncertain" in 13 cases and Siriraj scores in 17 cases; Sensitivity, specificity, positive and negative predictive values, for haemorrhage were 0.53, 0.96, 0.77 and 0.90, for Allen scores and 0.79, 0.97, 0.88, and 0.95 for Siriraj scores; such values for infarction were 0.91, 0.89, 0.97, and 0.71 for Allen scores and 0.80, 0.95, 0.98 and 0.53 for Siriraj scores.
Conclusion: When CT-Scan is not immediately available and the clinician wishes to start antithrombotic treatment, the Siriraj score (and possibly the Allen score) can be useful to identify patients at low risk of intracerebral hemorrhage and The Siriraj score is simple, cheap, reliable and practical method which can be used immediately after the stroke.

Keywords: Ischemic stroke IS, intracerebral hemorrhage ICH, computerized tomography (CT-Scan), Allen Hospital score (AS), Siriraj stroke Score (SS).