The importance of scales for treating brain stroke

Prema Svjetskoj zdravstvenoj organizaciji, moždani udar je klinički sindrom definiran kao naglo nastali žarišni, ili rjeđe, globalni neurološki deficit koji traje dulje od 24 sata ili dovodi do smrti, a može se objasniti cerebrovaskularnim poremećajem. Razlikujemo ishemijski i hemoragijski moždani udar. Moždani udar je akutno stanje koje zahtjeva ranu intervenciju i hitno liječenja. Prema epidemiološkim podacima moždani udar je vodeći uzrok onesposobljenosti u odrasloj dobi u Sjedinjenim Američkim državama, treći je uzrok po smrtnosti u zemljama zapadne Europe, drugi uzrok smrtnosti u Hrvatskoj i prvi uzrok invalidnosti, a drugi vodeći uzrok smrti širom svijeta 2013. godine American Heart Association i American Stroke Association su izdale nove smjernice za rano zbrinjavanje pacijenata s ishemijskim moždanim udarom. 2015. godine učinjena je nadopuna smjernica iz 2013. godine za rano zbrinjavanje ishemijskog moždanog udara uključujući endovaskularno liječenje. Američka akademija za neurologiju priznala je ovu vrstu smjernica kao edukacijsku pomoć za liječnike neurologe. Ljestvice poput RACE (engl. Rapid arterial occlusion evaluation scale), FAST-ED (engl. Field assessment stroke triage for emergency destination), C-STAT (engl. Cincinnati stroke triage assessment tool) i LAMS (engl. Los angeles motor scale) su ljestvice koje imaju veliku važnost u ranom, hitnom otkrivanju akutnog zbivanja u procesu nastanka moždanog udara te se koriste od tada i pridonose bržem otkrivanju i zbrinjavanju pacijenata. Od kliničke važnosti za početak liječenja i praćenja tijekom liječenja bitna nam je i NIHSS (engl. National institutes of health stroke scale) ljestvica. Ljestvica NIHSS se koristi u procjeni pacijentova stanja za primjenu trombolitičke terapije u liječenju moždanog udara. Zaključno je bitno utvrditi važnost ljestvica koja se očituje u što ranijoj intervenciji te mogućnosti zbrinjavanja pacijenta u vanbolničkim i bolničkim uvjetima unutar zlatnog sata i postizanja boljih rezultata u liječenju moždanog udara i sprječavanju njegovih posljedica.According to the World Health Organization, stroke is a clinical syndrome defined as the sudden centered or (more rarely) global neurological deficit which lasts for more than 24 hours or leads to death, with the option of being explained through a cerebro-vaskular disease. It can be differentiated between 2 main types of stroke: ischemic and hemorrhagic. Stroke is an acute state which needs an early intervention and urgent treatment. Following the epidemiological data, stroke is the leading cause of the inabilities among the adults in the United States of America, as well as the third cause of death in the Western Europe. It is also the second cause of death in Croatia, alongside being the first cause of the disabilities, and the second death causator worldwide. In 2013 American Heart Association and American Stroke Association made new guidelines for the early menagement of patient with acute ishemic stroke. In 2015 Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment. The American academy of Neurology affirms the value of this guideline as an educational tool for neurologist. Those guideline addresses opportunities for optimal stroke care in the acute phase of the acute ishemic stroke. Scale like RACE (Rapid arterial occlusion evaluation scale), FAST-ED (Field assessment stroke triage for emergency destination), C-STAT (Cincinnati stroke triage assessment tool) and LAMS (Los angeles motor scale) are the scales which carry a great importance in early and urgent detection of the acute changes in the process that leads to stroke. Therefore, these scales are mostly used in this process and they contribute to faster and more precise results, as well as taking care of the patients. What is also very important in the clinical contet of the treatment is the National Institutes of Stroke Scale/Score scale (NIHSS). This score has been used in thrombolysis trials to include or exclude patients from active treatment. In conclusion, it is very important to point out the importance of these scales in as early diagnosis as possible, and furthermore treatment of the patients in hospital and out-of-hospital contexts within the golden hour, and all of this with the same aim to achieve faster and better treatments and prevetnion of stroke