• Journal of Korean Physical Therapy Science
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• v.9 no.1
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• pp.103-111
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• 2002

The purpose of this study was NIHSS(National Institutes of Health stroke scale) to activities of Daily Living stroke patient. We designed a 17 item neurogic Examination NIHSS use in acute stroke therapy trials. In a study of stroke patient. Assessment were measured by the NIHSS and by the MBI (Modified Barthel Index) to evaluate activities of daily living(ADL). Fifty patients were subject in this study. Collected data analysis were completed by using t-test, ANOVA, correlation analysis and Multiple regression analysis. The following were as follow; Among the test of NIHSS(National Institutes of Health stroke scale) was significantly correlated with changes in MBI(Modified Barthel Index) score in 50 stroke patients. Among the subitems of NIHSS, Pupillary Response, a level of consciousness, best motor arm, best motor leg were the best predictors of functional improvement.

• Quality Improvement in Health Care
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• v.15 no.2
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• pp.73-81
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• 2009

문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로 활용하고 있지만 아직 간호현장에서는 보편적으로 사용하지 않고 있다. 이에 뇌졸중 환자 간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중 환자 간호의 질을 보다 향상시키기 위하여 본 활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를 향상시키기 위한 프로그램을 개발 적용한다. 둘째, 간호사가 급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중 악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬 수 있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과 치료를 위한 의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실. 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 "NIHSS 간호사 교육 프로그램"을 마련하였다. 둘째, NIHSS 측정을 통한 뇌졸중 악화 예측율 향상을 위하여 "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"을 개발하고 추적 관찰하였다. 개선효과: NIHSS 측정 신뢰도는 질 향상 활동 전 89%에서 92%로 향상되었다. 그리고 간호사의 뇌졸중 악화 양성 예측율은 58.7%에서 87.1%로 향상되었다(참고 : 간호사의 뇌졸중 악화 음성 예측율 100% 유지). 즉 "NIHSS 간호사 교육 프로그램 활용", "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"의 적용으로 뇌졸중의 조기 발견 및 치료가 가능하였고, 향후 환자 예후에 긍정적인 영향을 줄 수 있을 것이라 기대된다.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.727-732
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• 2007

Objectives : This study investigated using National Institutes of Health Strokes Scale in acute and subacute stroke patients and evaluated relativity of pulse pattern to NIHSS. Methods : 104 acute and subacute stroke patients were selected from 4 oriental medical hospitals from April 2007 to May 2007. The patients were admitted to hospital within 1 month after stroke. Pulse feeling diagnosis was done by oriental medical doctor and classified into 7 subtypes. Results : There were significant results statistically between slow/rapid pulse and NIHSS score in the male group; in the female group, there were no significant results statistically but the results showed that slow pulse has lower NIHSS score than rapid pulse. Patients with surging pulse had lower NIHSS score than the other patients. Another pulse pattern had no relativity to NIHSS score.

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.57-68
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• 2013

Purpose: In assessing patients' neurological status following a stroke it is very important to have a valid tool for early detection of neurological deterioration. NIHSS is considered the best tool to reflect neurological status in patients with ischemic stroke. An education program on use of NIHSS was planned for nurses caring for these patients and the effects of the program were evaluated. Methods: The NIHSS education program (NEP) which includes online and video lectures, and practical education was provided to the nurses from April to July, 2010. To examine the effect of NEP, nursing records of patients with ischemic stroke who were admitted to a stroke center were analyzed. Two groups, a historical control group (n=100) and the study group (n=115) were included. Results: Nursing records for neurologic symptoms for each patient increased (41.0% versus 100.0%, p<.001), and especially, visual disturbance, facial palsy. limb paralysis and ataxia, language disturbance, dysarthria, and neglect symptoms significantly increased (all p<.001). Nurse notification to the doctor of patients with neurological changes increased (21.0% versus 39.1%, p=.004), and nurses' neurological deterioration detection rates also increased (37.5% versus 84.6%, p=.009). Conclusion: NEP improved the quality of nursing records for neurological assessment and the detection rate of neurological deterioration.

• The Journal of Korean Medicine
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• v.28 no.4
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• pp.168-175
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• 2007

Objectives : This is a study of ischemic stroke patients designed for comparing Korean and Western medical treatments and Korean medical treatments alone. Methods : 44 patients were diagnosed by B-MRI scan as having suffered ischemic stroke. They had entered Dong-eui Korean Medicine hospital within seven days of attack, and remained over seven days, all between May 2005 and October 2007. Patients were divided into two groups; a group treated with Korean medical treatments, and another group treated with Korean and Western medical treatments (but in both groups examinations were done and Western medications were given for hypertension, diabetes mellitus and so on) Results : NIHss change one month later was not statistically significant for either groups but the NIHss gap between them was significant. Conclusions : NIHss change one week later was not statistically significant for either group. NIHss change one month later was not statistically significant for either groups but the Korean medical treatment group had a significant NIHss gap more than the Korean and Western medical treatment group.

• The Journal of Internal Korean Medicine
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• v.23 no.1
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• pp.5-13
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• 2002

Purpose : Studies on stroke were conducted by using the scaling system to estimate, compare severity and to predict prognosis. National Institute of Health Stroke Scale is widely used for this purpose due to its accuracy in predicting clinical symptoms. According to previous studies, neurologic symptoms in acute stage of ischemic stroke did not disappear, and approximately 27% to 43% of them were aggravated, We conducted this study to define clinical aggravation and to improve ischemic stroke in its acute stage by using NIHSS. Methods and Subjects : Due to their acute ischemic stroke, twenty five patients visited Wonkwang Oriental Medicine in Cheonju within forty eight hours from its beginning stage. Two oriental medicine doctors checked NIHSS every six hours during the first ninety six hours and later every twenty four hours for twelve days from the beginning of the disease. Results : The Aggravated group consisted of nineteen out of twenty five cases, which is seventy six % and NIHSS on admissions were $5.88{\pm}0.63$ and it increased linearly over time by the equation of NIHSS on admissions was $8.50{\pm}2.02$ and it decreased linearly over time by the equation of NIHSS=-0.01 one hour+7.91. Conclusion : During the study, we defined the clinical courses of acute ischemic stroke. There have been no reports on this so far. Therefore, we hope that this study will be beneficial to expand the scope of oriental medicine in dealing with aggravating ischemic stroke in the acute stage.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.65-74
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• 2004

Object : This is a study of acute stage stroke patients designed for comparison of combined Eastern and Western medical treatments and Oriental treatments alone. Methods : 51 patients were diagnosed by Brain-CT and Brain-MRI scan as having suffered stroke. They had entered Dong-eui hospital within seven days of attack, and remained over seven days, all between November 2002 and August 2003. Patients were divided into two groups: a group treated with both Eastern and Western medical treatments, and a group treated only with Oriental medical treatments (but examinations were done and medications were given in hypertension, Diabetes Mellitus and so on). Results : The Eastern-Western medical treatment group showed significant changes in NIHSS. A rate of improvement figure of 24.94% was obtained for the Eastern-Western medical treatment group, and for the Oriental medical group a figure of 7.84% was obtained. Conclusion : The East-West medical treatment group had significant rate of development that measure for NIHSS by treated comparatively dependent patients. And oriental medical treatment group had significant rate of development that measure for NIHSS by treated comparatively independent patients. The NIHSS measure for the Eastern-Western medical treatment group shows a significant rate of improvement for relatively dependent patients, and the NIHSS measure for the Oriental medical treatment group shows a significant rate of development for relatively independent patients.

• The Journal of the Society of Stroke on Korean Medicine
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• v.9 no.1
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• pp.1-7
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• 2008

Objectives : We questioned whether the tongue diagnosis is effective for judging seriousness of cerebrovascular accidents. This study is about the relationship between tongue diagnosis and National Institute of Health Stroke Scale(NIHSS) in acute stroke patients. Methods : 738 subjects were recruited from the patients admitted to the department of internal medicine at Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center from April 2007 to August 2008. We looked at the tongue as in three dimensions of tongue color, tongue fur color and tongue body. And, we calculated NIHSS means according to the subtypes of three dimensions. Results : 1. In the Tongue color, from the most commom to least common colors were pale red, red, pale, bluish purple, and ect. The NIHSS mean score of red is significantly higher than pale and pale red. 2. In the Tongue fur color, white fur was the most common, and then yellow fur, etc. There is no significant difference among three subtypes in the NIHSS mean score. 3. In the Tongue body, etc. is the most common, followed by teeth-marked tongue, enlarged tongue, blood patchy tongue, and mirror tongue. The NIHSS mean score of teeth-marked tongue is significantly lower than blood patchy tongue and mirror tongue. Conclusions : The tongue color and the tongue body are useful indexes for judging seriousness of cerebrovascular accidents presented by NIHSS. But in our study, the tongue fur color was not useful. Further study is necessary on the tongue fur.

• The Journal of Korean Medicine
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• v.24 no.1
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• pp.65-73
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• 2003

Objective: The aim of this study was to investigate the effect of scalp acupuncture on recovery from motor disorders in stroke patients. Methods: Twenty-two patients with post-stroke hemiplegia were randomized into two groups. Ten patients (test group) were treated by 2 methods: scalp acupuncture and general acupuncture. The other twelve patients (control group) were treated only with general acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale (NIHSS) and Modified Barthel Index (MBI). The therapy was performed once a day for 2 weeks. Results: In terms of NIHSS score, the test group showed statistically meaningful decrease after 2 weeks treatment, while the control group showed statistically meaningful decrease after 1 week (p<0.05). And in terms of score of MBI, the test group did not show statistically meaningful increase but the control group showed statistically meaningful increase after 1 week (p<0.05). There was no statistically meaningful difference after 1 and 2 weeks treatment between the groups. Conclusions: These results support that the test group has almost same the effectiveness compared with the control group in improvement of the activity of daily living of post-stroke hemiplegic patients.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.192-196
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• 2015

Objective : The aim of this study is to investigate good prognostic factors for an acute occlusion of a major cerebral artery using mechanical thrombectomy. Methods : Between January 2013 to December 2014, 37 consecutive patients with acute occlusion of a major cerebral artery treated by mechanical thrombectomy with stent retrievers were conducted. We analyzed clinical and angiographic factors retrospectively. The collateral flow and the result of recanalization were sorted by grading systems. Outcome was assessed by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at 90 days. We compared the various parameters between good and poor angiographic and clinical results. Results : Twenty seven patients demonstrated good recanalization [Thrombolysis in Cerebral Infarction (TICI) 2b or 3] after thrombectomy. At the 90-day follow up, 19 patients had good (mRS, 0-2), 14 had moderate (3-4) and four had poor outcomes (5-6). The mRS of older patients (${\geq}75years$) were poor than younger patients. Early recanalization, high Thrombolysis in Myocardial Infarction risk score, and low baseline NIHSS were closely related to 90-day mRS, whereas high TICI was related to both mRS and the decrease in the NIHSS. Conclusion : NIHSS decreased markedly only when recanalization was successful. A good mRS was related to low initial NIHSS, good collateral, and early successful recanalization.