Abstract
Objective
To conduct a scoping review on classifications of mild stroke based on stroke severity
assessments and/or clinical signs and symptoms reported in the literature.
Data Sources
Electronic searches of PubMed, PsycINFO (Ovid), and Cumulative Index to Nursing and
Allied Health (CINAHL–EBSCO) databases included keyword combinations of mild stroke,
minor stroke, mini stroke, mild cerebrovascular, minor cerebrovascular, transient
ischemic attack, or TIA.
Study Selection
Inclusion criteria were limited to articles published between January 2003 and February
2018. Inclusion criteria included studies (1) with a definition of either mild or
minor stroke, (2) written in English, and (3) with participants aged 18 years and
older. Animal studies, reviews, dissertations, blogs, editorials, commentaries, case
reports, newsletters, drug trials, and presentation abstracts were excluded.
Data Extraction
Five reviewers independently screened titles and abstracts for inclusion and exclusion
criteria. Two reviewers independently screened each full-text article for eligibility.
The 5 reviewers checked the quality of the included full-text articles for accuracy.
Data were extracted by 2 reviewers and verified by a third reviewer.
Data Synthesis
Sixty-two studies were included in the final review. Ten unique definitions of mild
stroke using stroke severity assessments were discovered, and 10 different cutoff
points were used. The National Institutes of Health Stroke Scale was the most widely
used measure to classify stroke severity. Synthesis also revealed variations in classification
of mild stroke across publication years, time since stroke, settings, and medical
factors including imaging, medical indicators, and clinical signs and symptoms.
Conclusions
Inconsistencies in the classification of mild stroke are evident with varying use
of stroke severity assessments, measurement cutoff scores, imaging tools, and clinical
or functional outcomes. Continued work is necessary to develop a consensus definition
of mild stroke, which directly affects treatment receipt, referral for services, and
health service delivery.
Keywords
List of abbreviations:
BI (Barthel Index), CINAHL (Cumulative Index to Nursing and Allied Health), CNS (Canadian Neurological Scale), CT (computed tomography), FMA (Fugl-Meyer Assessment), GCS (Glasgow Coma Scale), ICF (International Classification of Functioning, Disability, and Health), MMSE (Mini–Mental State Examination), MRI (magnetic resonance imaging), mRS (modified Rankin scale), NIHSS (National Institutes of Health Stroke Scale), PET (positron-emission tomography), SSS (Scandinavian Stroke Scale), TIA (transient ischemic attack)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 27, 2020
Footnotes
Supported by the National Institute on Aging (grant nos. P30AG024832 and P30AG059301), the National Institute on Disability, Independent Living, and Rehabilitation Research (grant nos. 90DP0028 and 90SFGE0002), and the Agency for Healthcare Research and Quality (grant no. R24HS022134).
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
