China
Africa
Explore chapters and articles related to this topic
Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
The National Institutes of Health Stroke Scale (NHISS – see Appendix A) is used to rate stroke severity. Typically, very severe strokes (scores of 25 or above) are considered inappropriate for thrombolysis due to higher risk of adverse outcome. Also, mild strokes (scores < 5) are often excluded on the basis that risks may exceed possible functional gains, although an exception might be made for isolated aphasia (as it would have a large functional impact).
Neurological Diseases
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Vital signs and cardiac and complete neurological exams are required. Scales such as the National Institutes of Health Stroke Scale and the ABCD1,2 Scoring System (for TIA) may be used (Table 11.6.2).
The Rasch Model Applied across the Human Sciences
Published in Trevor G. Bond, Zi Yan, Moritz Heene, Applying the Rasch Model, 2020
Trevor G. Bond, Zi Yan, Moritz Heene
When we learn that the Stroke Council of the American Heart Association recommended the use of the National Institutes of Health Stroke Scale (NIHSS) for assessing acute stroke and for the evaluation of neurologic impairment after stroke, the efforts of Millis, Straube, Iramaneerat, Smith, and Lyden (2007) to assess its psychometric properties seem well grounded. Although expert opinion was involved in the selection of the 15 NIHSS items on the basis of the empirical literature, some of those items have been subsequently shown to be unreliable, redundant, or not related to the underlying latent trait. Recommendations to shorten the instrument have been confounded by factor analyses results suggesting two (rather than one) underlying constructs representing left and right functions—depending on the location of the patient’s lesion. The risk for patient care and treatment derives from the possibility that the same NIHSS score might have different implications, depending on the lesion location (right v. left cerebral hemisphere).
Long-term trajectories of community integration: identification, characterization, and prediction using inpatient rehabilitation variables
Published in Topics in Stroke Rehabilitation, 2023
Alejandro Garcia-Rudolph, Joan Sauri, Katryna Cisek, John D. Kelleher, Vince Istvan Madai, Dietmar Frey, Eloy Opisso, Josep María Tormos, Montserrat Bernabeu
All patients admitted to the rehabilitation unit are referred from different acute care setting hospitals and fulfill the hospital criteria for admission, which include SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) objectives30 and support for discharge in case of severe disability. The rehabilitation program includes 5 h of intensive treatment oriented toward cognitive, swallowing, behavioral, and physical problems as well as training in activities of daily life living. Variables related to the rehabilitation program such as the time in between onset of injury and initiation of the rehabilitation program (Time from onset to Admission (days)) and length of stay (LOS) were also reported. At hospital admission, stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Medical complications and comorbidities were collected from the participants’ electronic health records. The following were included: aphasia, diabetes, dyslipidemia, dysphagia, hypertension, atrial fibrillation, neglect, affected side, dominance, educational level, smoking habits.
Aligning formal and functional assessments of Visuospatial Neglect: A mixed-methods study
Published in Neuropsychological Rehabilitation, 2022
Margaret Jane Moore, Rebecca Driscoll, Michael Colwell, Olivia Hewitt, Nele Demeyere
This study represents a secondary analysis of data collected as a component of Oxford Cognitive Screen (OCS) studies between 2015 and 2020. These protocols were approved by the National Research Ethics Committee (11/WM/0299,14/LO/0648). All participants provided informed consent in line with the Declaration of Helsinki. Participants were included if they completed the OCS Cancellation Task and had a documented systematic wash and dress and/or kitchen occupational therapy observational assessment within the first three weeks following stroke. In total, 290 patients (age = 73.4(range = 18–94), 43.3% female, 7.6% left handed) were included in this investigation. This sample contained 228 ischemic stroke, 42 haemorrhagic stroke, and 11 unreported stroke type patients. Stroke locations were recorded from routine clinical imaging as 125 right hemisphere, 69 left hemisphere, 24 bilateral, 51 not yet visible, and 12 unreported. This sample had an average National Institutes of Health Stroke Scale total score of 0.71(SD = 0.455, range = 0–23).
A scoping review of psychoeducational interventions for people after transient ischemic attack and minor stroke
Published in Topics in Stroke Rehabilitation, 2021
Eirini Kontou, Jade Kettlewell, Laura Condon, Shirley Thomas, Abigail R. Lee, Nikola Sprigg, Dame Caroline Watkins, Marion F. Walker, Farhad Shokraneh
Although all studies state that they included TIA and/or minor stoke participants, the definition of diagnoses was variable and, in some cases unclear. The diagnosis of minor/mild stoke across the studies was (i) National Institutes of Health Stroke Scale (NIHSS) score of ≥1, 0 to 5, ≤3, or ≤15; (ii) score >8.5/11.5 on the Canadian Neurological Scale; (iii) a modified Rankin Score between 0 and 2; (iv) Barthel Index score of >60 or ≥65; (v) minor stroke confirmed by positive findings on CT or MRI of the head. There was no common definition of minor stroke, and no explicit definition of TIA. The number of participants with a TIA versus minor stroke diagnosis was not clearly reported in one study24 and three studies included both diagnoses but did not report the numbers.23,25,26