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Original Research Article Computed tomography (CT) scan is the gold standard investigation used to distinguish cerebral infarction and hemorrhage. However early access to CT is not always feasible. In the past many Investigators have proposed various scoring systems to differentiate cerebral infarct and hemorrhage based on clinical findings. Siriraj Stroke Score (SSS) is one of the commonly used clinical stroke score. The aim of our study was to validate sensitivity, specificity and accuracy of SSS in differentiating cerebral infarct and hemorrhage in comparison with CT brain findings. 100 cases of acute stroke were included in the study. SSS for these patients was calculated at the time of admission. Sensitivity and specificity of SSS for infarction and hemorrhage were tested against CT brain. Findings recorded and statistically analyzed. Statistical Package for Social Sciences (SPSS) version 20 was used for statistical analysis. Among 100 patients, CT brain showed cerebral infarction in 75 and hemorrhage in 25 patients. The sensitivity of SSS for infarction was 84.75% and specificity was 95.24% and the sensitivity for hemorrhage was 95.24% and specificity was 84.75%. The overall accuracy of SSS was 87.5%. This study showed that SSS is fairly reliable in differentiating acute ischemic stroke from acute hemorrhagic stroke, but efforts should be made to make neuroimaging available and affordable in resource poor settings, as critical decisions cannot be made in acute stroke without imaging. In our study SSS showed good sensitivity and specificity and a good predictive accuracy, however as the results are not comparable with gold standard test (Neuroimaging), SSS cannot be used as a diagnostic tool. However as it has good sensitivity and specificity, it can be used as a screening tool to classify patients into stroke subtypes. It can be used for epidemiological purposes and as a bedside tool to differentiate type of stroke.

“Validity of Siriraj Stroke Score in Differentiating Acute Ischemic and Hemorrhagic Stroke”