Clinical event adjudication: Stroke
Editors-in-Chief: C. Michael Gibson, M.S., M.D. [1]
This chapter presents definitions used in the Clinical Event Committee adjudication processes. These definitions are current as of 3/26/10.
Stroke is an acute symptomatic episode of neurological dysfunction attributed to a vascular cause.
Classification
- A. Ischemic Stroke
- Ischemic stroke is defined as an acute symptomatic episode of focal cerebral, spinal, or retinal dysfunction caused by an infarction of central nervous system tissue.
- B. Hemorrhagic Stroke
- Hemorrhagic stroke is defined as an acute symptomatic episode of focal or global cerebral or spinal dysfunction caused by a nontraumatic intraparenchymal, intraventricular, or subarachnoid hemorrhage.
- C. Undetermined Stroke
- Undetermined stroke is defined as a stroke with insufficient information to allow categorization as A or B.
Stroke Disability
Stroke disability should be measured by a reliable and valid scale in all cases. For example, the modified Rankin Scale may be used to address this requirement:
| Scale | Disability |
| 0 | No symptoms at all |
| 1 | No significant disability despite symptoms; able to carry out all usual duties and activities |
| 2 | Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance |
| 3 | Moderate disability; requiring some help, but able to walk without assistance |
| 4 | Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance |
| 5 | Severe disability; bedridden, incontinent and requiring constant nursing care and attention |
| 6 | Dead |