To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke.
A cross-sectional study.
The study was carried out between September 2001 and May 2002 at the Department of Medicine, Civil Hospital, Karachi.
The study included 50 patients who presented to Civil Hospital, Karachi, during the study period with acute stroke and were evaluated with CT scan of brain. Only those patients were enrolled in the study that had acute ischemic stroke. The enrolled subjects were then evaluated for the neurological impairment using National Institute of Health Stroke Scale (NIHSS). The subjects were followed-up and their functional outcome was assessed using Barthel index (BI) on the 7th day of their admission.
Of the fifty patients enrolled in the study, 31(62%) were males and 19 (38%) were females, with age ranging from 45 years to 95 years and a mean age of 59.9 years. Neurological impairment at presentation was assessed by NIHSS. The score ranged between 2 and 28. The functional outcome was evaluated on the 7th day using Barthel index (BI), which ranged from 0 to 80. NIHSS score was found to be a good predictor of functional outcome in patients with ischemic stroke (p<0.001). Other factors like gender, hypertension and heart disease did not affect the functional recovery in such patients. Various factors were found to be significant for early prediction of stroke recovery. The NIHSS score was the strongest predictor of outcome after ischemic stroke. Age at the time of the event was also found to be an important predictor for stroke recovery.
The NIHSS score is a good predictor of patient' recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan.
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"The ability to evaluate balance and predict recovery of balance after a stroke may help in planning rehabilitation . Several clinical and demographic factors, including the severity of initial neurological deficit, lesion size, lesion location and age, have been suggested as predictors of recovery after stroke[10,11]. Evoked potentials (EPs) provide an objective and direct method by which to assess the integrity of sensory and motor pathways of the central nervous system. "
[Show abstract][Hide abstract] ABSTRACT: To investigate the association between baseline motor evoked potential (MEP) and somatosensory evoked potential (SSEP) responses in the lower extremities and balance recovery in subacute hemiparetic stroke patients.
MEPs and SSEPs were evaluated in 20 subacute hemiparetic stroke patients before rehabilitation. Balance (static posturography and Berg Balance Scale [BBS]), motor function (Fugl-Meyer Assessment [FMA]) and the ability to perform activities of daily living (Modified Barthel Index [MBI]) were evaluated before rehabilitation and after four-weeks of rehabilitation. Posturography outcomes were weight distribution indices (WDI) expressed as surface area (WDI-Sa) and pressure (WDI-Pr), and stability indices expressed as surface area (SI-Sa) and length (SI-L). In addition, all parameters were evaluated during eyes open (EO) and eyes closed (EC) conditions.
The MEP (+) group showed significant improvements in balance except WDI-Sa (EC), FMA, and MBI, while the MEP (-) group showed significant improvements in the BBS, FMA, and MBI after rehabilitation. The SSEP (+) group showed significant improvements in balance except SI-Sa (EO), FMA, and MBI, while the SSEPs (-) group showed significant improvements in the BBS, MBI after rehabilitation. The changes in the SI-Sa (EO), SI-L (EO), total MBI, and several detailed MBI subscales in the MEP (+) group after rehabilitation were significantly larger than those in the MEP (-) group.
Our findings suggest that initial assessments of MEPs and SSEPs might be beneficial when predicting balance recovery in subacute hemiparetic stroke patients.
Full-text · Article · Jun 2015 · Annals of Rehabilitation Medicine
"Behavioural examinations are the main means to determine early neuronal death after cerebral ischemic injury and are also a way to evaluate the restoration of neurological function caused by neuroplasticity. Since Longa et al.  developed their criteria for the evaluation of neurological deficits caused by cerebral ischemia in animals, this neurological deficit score has improved greatly and is now broadly applied to estimate the curative effects of diverse treatments on many kinds of animals . Our research showed a rapid decline in rat behavioural scores after MCAO. "
[Show abstract][Hide abstract] ABSTRACT: Background. Cerebral ischemia is known to produce brain damage and related behavioural deficits, including memory deficits and motor disorders. Evidence shows that EA significantly promotes recovery of neurological function and thus improves quality of life. Objective. Evidence exists for the involvement of catecholamines in human neuroplasticity. A better understanding of dopaminergic (DAergic) modulation in this process will be important. Methods. A total of 72 adult male Sprague-Dawley (SD) rats were divided into 6 groups: normal, model, EA, spiperone group, EA + spiperone group, and pergolide. The middle cerebral artery occlusion (MCAO) model was used in all 6 groups except the normal group. A behavioural assessment was conducted at 1, 3, 5, and 7 days after MCAO. The percent of brain infarct area was also determined 7 days after MCAO. Tyrosine hydroxylase (TH) and growth-associated protein 43 (GAP-43) fluorescence double labeling was performed in the striatum. Results. In this study, we found that EA at Fengchi (GB20) acupoints resulted in marked improvements based on a behavioural assessment. Both TTC staining and GAP-43 immunofluorescence labeling results showed that EA treatment reduced ischemia injury and promoted neuroplasticity compared with the model group. The D2R-selective agonist, pergolide, showed similar results, but these results were reversed by the D2R-selective antagonist, spiperone. We also found that there were more colocalization and expression of GAP-43 and TH in the EA and pergolide groups than those in the other groups. Conclusion. These results suggest that the neuroplasticity induced by EA was mediated by D2 autoreceptors in DAergic neurons.
Full-text · Article · Nov 2013 · Evidence-based Complementary and Alternative Medicine
[Show abstract][Hide abstract] ABSTRACT: The National Institute of Health Stroke Scale (NIHSS) and the Scandinavian Stroke Scale (SSS) are commonly used in clinical stroke trials. Use of different scales in trials makes comparison of outcomes difficult.
Adult patients with an acute stroke were recruited within 24 h of onset, and NIHSS, SSS and Glasgow Coma Scale scores were assessed at baseline and repeated at 1 week.
A total of 144 patients were included (46% males, mean age = 73 years). At presentation the median SSS score was 38 (2-58), and a week later 40 (4-58), the median NIHSS score at presentation was 5 (0-29) and a week later 3 (0-27). Changes in both scales were strongly correlated, r = 0.76, p < 0.001. Both were good predictors of mortality. Linear regression analysis produced an equation relating the two: SSS = 50 - 2 x NIHSS.
No preview · Article · Oct 2007 · Cerebrovascular Diseases