Background: Stroke is one of the leading cause of premature death globally. Early identification of ischaemic stroke is crucial. Neuro-Imaging techniques have been indispensable to distinguish between these Ischaemic and haemorrhagic stroke but infrequently available in rural areas. To overcome these difficulties and to enhance clinical bedside diagnosis, clinical scores have been developed. The most commonly used ones include Besson score (BS), Greek score (GS) and Siriraj score (SS). We aimed to identify the best among these scores

Methods: A cross sectional study was conducted on patients with stroke admitted in KLES Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi from Jan 2016 to Dec 2016.The diagnosis of stroke was entertained after fulfilling WHO definition of stroke by the patient. They were then scored according to the scoring systems and validity tests of these scores were obtained by comparing it with neuroimaging.

Results: 61 patients (42 patients (68.85%) ischemic stroke and 19 patients (31.15%) hemorrhagic stroke) were included in our study. For hemorrhagic stroke GS had the highest specificity (97.62%) while SS had the highest sensitivity (78.95%). For ischemic stroke BS had the highest specificity (94.74%) while SS had the highest sensitivity (80.95%). SS was better tool in identifying stroke type in our study [AUC (0.902)].

Conclusion: We found SS was a better scoring system for both types of strokes although all have certain limitations. Hence we feel neuroimaging is the still the best in differentiating the type of stroke.

Keywords: Besson score, Greek score, Siriraj score, stroke.

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Dr Anish J. Kuriakose

Department of Medicine, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India

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