Clinical predictors of cerebrovascular occlusion for patients presenting with acute stroke

Objective: We sought to determine clinical predictors of vascular occlusion in patients with stroke. Methods: From November 1994 to December 1999, 88 patients who were thrombolytic candidates and seen within 6 hours of stroke symptom onset had cerebral angiography. The Oxford Community Stroke Project clinical classification system, admission National Institutes of Health Stroke Scale score, and time from symptom onset until angiography were used to predict vascular occlusion. Results: In all, 79% of patients with total anterior circulation infarctions and 73% with partial anterior circulation infarctions had vascular occlusions, whereas only 29% with lacunar infarcts had occlusion. Strokes were more severe in patients with occlusion than in those without occlusion. Time to angiography was also associated with vascular occlusion. Conclusions: Clinical classification of stroke, stroke scales, and time to angiography are useful screening tools to predict cerebral occlusion in acute stroke patients.