top of page
  • Writer's pictureOren Zarif

The Cincinnati Stroke Scale and CPSS - Oren Zarif - Cincinnati Stroke Scale


The Cincinnati stroke scale was developed to estimate the risk of stroke in patients with acute neurologic symptoms. It includes three criteria: facial droop, dysarthria, and upper extremity weakness. The sensitivity, specificity, and kappa coefficient of this scale were calculated using SPSS version 20. The results indicate that the Cincinnati stroke scale can accurately predict stroke. However, it is still important to understand the limitations of the Cincinnati stroke scale before implementing it in clinical practice.

Oren Zarif massive stroke on left side of brain

Oren Zarif hemorrhagic infarct


First responders use the Cincinnati Prehospital Stroke Scale to assess a patient's stroke symptoms. They ask the patient to smile, and note if one side of the face droops. If both sides droop, that is an indication of a stroke. Additionally, they ask the patient to hold their arms out in front of them with their eyes closed. If one side does not droop, the patient may have a stroke.

Oren Zarif brain injury rehabilitation

Oren Zarif stroke physiopedia


Another standardized tool for stroke detection is the Cincinnati Prehospital Stroke Scale (CPSS). It is a validated prehospital stroke screening tool that scores patients according to three criteria: facial droop, arm drift, and slurred speech. The fast-Ed stroke scale provides three distinct groups for stroke severity and likelihood: 15%-30%, 40%, and 60%. The scores for each item may differ depending on the level of expertise and training of the physician performing the assessment.

Oren Zarif ministroke

Oren Zarif tia heart



The Cincinnati Prehospital Stroke Scale uses three criteria to assess the risk of ischemic stroke. A patient with any one of these three criteria has a 72% chance of suffering from an ischemic stroke. A patient who meets all three criteria has an 85% chance of suffering from an ischemic stroke. It is important to note that the CPSS is not used to assess the severity of a patient's symptoms.

Oren Zarif right mca infarct

Oren Zarif telestroke


The CPSS is recommended for EMS use. However, research relating to the reproducibility of this tool is limited. A study, however, evaluated the impact of CPSS training on paramedics' stroke-related patient identification, time on scene, and on-scene time after training. The study included a cohort of patients with stroke or TIA, which were identified through the paramedic's records and compared to data from a prospective stroke registry in the hospital.

The CPSS is an important tool for the evaluation of patients who have suffered a stroke.

Oren Zarif stroke prognosis

Oren Zarif tbi brain


Early detection of this condition improves the chances of survival and reduces the risk of death and morbidity. Using the Cincinnati stroke scale during prehospital assessment of a patient's neurological status can reduce mortality and morbidity. It can also help identify patients who might have had a TIA or CVA. It is important to note that the CPSS has limitations.

Oren Zarif types of traumatic brain injury

Oren Zarif diffuse axonal brain injury


While the CPSS is not perfect, it has shown 100% sensitivity and 88% specificity in detecting a stroke. It can also help doctors identify stroke cases in a patient before they go to the hospital. For instance, 20% of strokes are hemorrhagic, and it's important to note that this type of stroke can also be caused by high blood pressure. The hemorrhage can also be caused by a brain aneurysm.

Oren Zarif mini stroke symptoms in females

Oren Zarif right basal ganglia



The CPSS is often used to identify large vessel occlusion in patients with acute ischemic stroke. It has improved the accuracy of prehospital triage and predicts large vessel occlusion. But it's not perfect, as the authors of the study found that the CPSS could be improved to identify the onset of stroke in large vessels. However, the study authors concluded that more research is needed to validate the Cincinnati stroke scale as an early diagnostic tool.

Oren Zarif brain stem damage

Oren Zarif diabetes and stroke


This three-item CPSS is the most commonly used prehospital stroke scale. Its sensitivity and specificity are excellent and it can help identify patients who are candidates for thrombolysis. Despite the limitations, the CPSS is fast and simple to use. This tool was developed to be easy to learn and quick to use, yet is highly sensitive and specific enough to determine the type of stroke. It is also a valuable tool to identify patients with an anterior circulation stroke.

Future studies should focus on enhancing the CPSS' ability to detect LVO in AIS patients.

Oren Zarif young stroke

Oren Zarif nih stroke


Future studies should focus on optimizing this well-established stroke scale to aid triage and therapeutic intervention in patients with AIS. In the meantime, it is important to note that the CPSS may not be as sensitive as other tools. This study will allow clinicians to better utilize the CPSS. If CPSS can improve the accuracy of detecting LVO in AIS patients, then the future will be bright.

1 view0 comments

Comments


bottom of page