How well does the Oxfordshire Community Stroke Project classification predict the site and size of the infarct on brain imaging?

Citation
Ge. Mead et al., How well does the Oxfordshire Community Stroke Project classification predict the site and size of the infarct on brain imaging?, J NE NE PSY, 68(5), 2000, pp. 558-562
Citations number
12
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurology,"Neurosciences & Behavoir
Journal title
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
ISSN journal
0022-3050 → ACNP
Volume
68
Issue
5
Year of publication
2000
Pages
558 - 562
Database
ISI
SICI code
0022-3050(200005)68:5<558:HWDTOC>2.0.ZU;2-H
Abstract
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.