{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T17:19:17Z","timestamp":1763140757394,"version":"3.38.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,4,6]],"date-time":"2015-04-06T00:00:00Z","timestamp":1428278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Heart and Stroke Foundation of Alberta, NWT and Nunavut Professorship in Stroke Medicine"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Perfusion-weighted magnetic resonance imaging is not routinely used to investigate stroke\/transient ischemic attack. Many clinicians use perfusion-weighted magnetic resonance imaging selectively in patients with more severe neurological deficits, but optimal selection criteria have never been identified. <\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and\/or Hypothesis<\/jats:title><jats:p> We tested the hypothesis that a National Institutes of Health Stroke Scale score threshold can be used to predict the presence of perfusion-weighted magnetic resonance imaging deficits in patients with acute ischemic stroke\/transient ischemic attack. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> National Institutes of Health Stroke Scale scores were prospectively assessed in 131 acute stroke\/transient ischemic attack patients followed by magnetic resonance imaging, including perfusion-weighted magnetic resonance imaging within 72 h of symptom onset. Patients were dichotomized based on the presence or absence of perfusion deficits using a threshold of Tmax (time to peak maps after the impulse response) delay \u2265four-seconds and a hypoperfused tissue volume of \u22651 ml. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Patients with perfusion deficits (77\/131, 59%) had higher median (interquartile range) National Institutes of Health Stroke Scale scores (8 [12]) than those without perfusion deficits (3 [4], P &lt; 0\u00b7001). A receiver operator characteristic analysis indicated poor to moderate sensitivity of National Institutes of Health Stroke Scale scores for predicting perfusion deficits (area under the curve = 0\u00b7787). A National Institutes of Health Stroke Scale score of \u22656 was associated with specificity of 85%, but sensitivity of only 69%. No National Institutes of Health Stroke Scale score threshold identified all cases of perfusion-weighted magnetic resonance imaging deficits with sensitivity &gt;94%. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Although higher National Institutes of Health Stroke Scale scores are predictive of perfusion deficits, many patients with no clinically detectable signs have persisting cerebral blood flow changes. A National Institutes of Health Stroke Scale score threshold should therefore not be used to select patients for perfusion-weighted magnetic resonance imaging. Perfusion-weighted magnetic resonance imaging should be considered in all patients presenting with acute focal neurological deficits, even if these deficits are transient. <\/jats:p><\/jats:sec>","DOI":"10.1111\/ijs.12438","type":"journal-article","created":{"date-parts":[[2015,4,6]],"date-time":"2015-04-06T07:48:19Z","timestamp":1428306499000},"page":"582-588","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["National Institutes of Health Stroke Scale Score is an Unreliable Predictor of Perfusion Deficits in Acute Stroke"],"prefix":"10.1177","volume":"10","author":[{"given":"Victor","family":"Choi","sequence":"first","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahesh","family":"Kate","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayme C.","family":"Kosior","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Buck","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor","family":"Steve","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"McCourt","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Jeerakathil","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashfaq","family":"Shuaib","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek","family":"Emery","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Butcher","sequence":"additional","affiliation":[{"name":"Division of Neurology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,4,6]]},"reference":[{"key":"bibr1-ijs.12438","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.7.1581"},{"key":"bibr2-ijs.12438","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.2.418"},{"key":"bibr3-ijs.12438","first-page":"915","volume":"22","author":"Sunshine JL","year":"2001","journal-title":"AJNR Am J 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