Comparison of siriraj stroke score with computerized tomography in ascertaining stroke type among southindians

Abstract

Background and objective: Computed tomography (CT) scan is an accurate, noninvasive procedure, routinely used as an investigative tool to distinguish between cerebral infarction and haemorrhage. However, quick access to CT scan is not available in every country and hospital. Different investigators have tried to develop scoring systems which can be used at the bedside for diagnosing stroke subtypes. Siriraj Stroke Score and Guy’s hospital score are two popular stroke scores. The aim of this study was to differentiate between cerebral infarct and intracerebral haemorrhage on the basis of Siriraj stroke score and to find out the sensitivity, specificity and overall accuracy of the scoring system by comparing it with CT scan findings. Material and methods: One hundred (100) consecutive cases of acute stroke were studied. Siriraj Stroke Score (SSS) was calculated. Sensitivity and specificity of SSS for infarction and haemorrhage was tested against computed tomography scanning (CT) of brain as a gold standard. The findings were recorded and statistically analyzed. Results: Out of the total 100 patients, CT brain showed cerebral infarction in 71 patients and haemorrhage in 29 patients. The sensitivity of Siriraj score for detecting infarction was 87.93% and specificity was 77. 27%. The sensitivity of Siriraj score for detecting haemorrhage was 77.27% and specificity was 87.93%. The overall accuracy of Siriraj stroke score was 85%. Conclusion: In centers where CT scan is not available Siriraj Stroke Score can be used for the bedside diagnosis of the nature of the lesion in stroke patients.