Letter to the Editor Stroke welcomes Letters to the Editor and will publish them, if suitable, as space permits. Letters must reference a Stroke published-ahead-of-print article or an article printed within the past 3 weeks. The maximum length is 750 words including no more than 5 references and 3 authors. Please submit letters typed double-spaced. Letters may be shortened or edited.
Letter by Liu et al Regarding Article, “Leukoaraiosis Burden Significantly Modulates the Association Between Infarct Volume and National Institutes of Health Stroke Scale in Ischemic Stroke”
To the Editor: We read with interest the recent report by Helenius and Henninger1 describing data from a single-center registry of patients diagnosed with acute supratentorial ischemic stroke as shown on brain MRI. This study confirmed that leukoaraiosis significantly modulates the association between infarct volume and National Institutes of Health Stroke Scale (NIHSS). It is important to understand the factors modulating the association between NIHSS and infarct volume, which may help mitigate outcome differences in patients with stroke by improving proper assessment and guide evidence-based treatment strategies. We would like to highlight 3 important issues raised in the study by Helenius and Henninger. First, the validity of NIHSS scores in predicting arterial occlusion and infarct volume is time dependent, decreasing with increasing time from symptom onset to clinical evaluation.2 Helenius and Henninger’s study is a retrospective study that analyzed consecutive patients with acute supratentorial ischemic stroke who were prospectively included in their local stroke registry. In their study, NIHSS scores were just only assessed at the time of presentation by members of the stroke team certified in NIHSS, but not recorded time to clinical evaluation. Previous studies have showed that median NIHSS scores were higher in patients with time to clinical evaluation
Letter by Liu et al Regarding Article, “Leukoaraiosis Burden Significantly Modulates the Association Between Infarct Volume and National Institutes of Health Stroke Scale in Ischemic Stroke”
To the Editor: We read with interest the recent report by Helenius and Henninger1 describing data from a single-center registry of patients diagnosed with acute supratentorial ischemic stroke as shown on brain MRI. This study confirmed that leukoaraiosis significantly modulates the association between infarct volume and National Institutes of Health Stroke Scale (NIHSS). It is important to understand the factors modulating the association between NIHSS and infarct volume, which may help mitigate outcome differences in patients with stroke by improving proper assessment and guide evidence-based treatment strategies. We would like to highlight 3 important issues raised in the study by Helenius and Henninger. First, the validity of NIHSS scores in predicting arterial occlusion and infarct volume is time dependent, decreasing with increasing time from symptom onset to clinical evaluation.2 Helenius and Henninger’s study is a retrospective study that analyzed consecutive patients with acute supratentorial ischemic stroke who were prospectively included in their local stroke registry. In their study, NIHSS scores were just only assessed at the time of presentation by members of the stroke team certified in NIHSS, but not recorded time to clinical evaluation. Previous studies have showed that median NIHSS scores were higher in patients with time to clinical evaluation
