Objectives-The Oxfordshire Community Stroke Project (OCSP) classification i
s a simple clinical scheme for subdividing first ever acute stroke. Several
small studies have shown that when an infarct is visible on CT or MRI, the
classification predicts its site in about three quarters of patients. The
aim was to further investigate this relation in a much larger cohort of pat
ients in hospital with ischaemic stroke.
Methods-Between 1994 and 1997, inpatients and outpatients with ischaemic st
roke were assessed by one of several stroke physicians who noted the OCSP c
lassification. A neuroradiologist classified the site and extent of recent
infarction on CT or MRI.
Results-Of 1012 patients with ischaemic stroke, 655 (65%) had recent visibl
e infarcts. These radiological lesions were appropriate to the clinical cla
ssification in 69/87 (79%) patients with a total anterior circulation syndr
ome, 213/298 (71%) with a partial anterior circulation syndrome, 105/144 (7
3%) with a lacunar syndrome, and 105/126 (83%) with a posterior circulation
syndrome. Overall, 75% of patients with visible infarcts were correctly cl
assified clinically. If patients without a visible infarct did have an appr
opriate lesion in the brain (best case), the classification would have corr
ectly predicted its site and size in 849/1012 (84%) patients, compared with
only 492/1012 (49%) in the worst case scenario.
Conclusion-The OCSP classification predicted the site of infarct in three q
uarters of patients. When an infarct is visible on brain imaging, the site
of the infarct should guide the use of further investigations, but if an in
farct is not seen, the OCSP classification could be used to predict its lik
ely size and site.