CLINICAL-DIAGNOSIS OF THE ACUTE STROKE SYNDROME

Abstract

To assist physicians without easy access to CT [computerized tomography] scanning facilities, a scoring system was devised to aid the clinical diagnosis of acute stroke. A consecutive series of 192 patients < 76 yr old was studied prospectively from admission. The clinical features of 174 (91%) of these patients were compared with their subsequent CT scan or autopsy diagnosis. The scoring system derived from this analysis determines the relative likelihood of infarction or hemorrhage from quantitative assessment of 8 clinical variables. Clinical diagnosis with this method was more accurate than the diagnosis made by the patient''s physicians. Lumbar puncture performed in 72 patients added little to the accuracy of diagnosis. Nine patients had mass lesions, of whom only 1 presented with a clear history. Consulsions and neurological deficits which were prolonged or discontinuous in evolution occurred more frequently in patients with mass lesions than in those with vascular lesions.