الفهرس 
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Abstract
he National Institutes of Health Stroke Scale (NIHSS) has been validated in the 1990s as the most appropriate tool in assessment patients of acute stroke. However, it was found to be biased towards the left hemispheric and motoric functions providing minimal assessment to the language, right hemispheric and cognitive functions. The need to complement the role of the NIHSS is necessary to aid in an accurate and as rapid as possible assessment for patients with acute ischemic strokes in order to provide the appropriate way of management. We hypothesized that combining the NIHSS with a quantitative analysis of a picture description task as used in the Spoken Picture Description subscale of the Comprehensive Aphasia Test could provide valuable information about prediction of site, size and side of acute ischemic stroke.
We examined 86 patients with acute ischemic stroke from the ASUSH and Al-demerdash hospitals with the NIHSS and SPD-CAT within 48 hours of occurrence of stroke and finding the correlation between their scores (individually and combined with the subscales scores) and the characteristics of the acute ischemic stroke such as the site, side, volume, the lesion volume percent to the whole brain volume and their TOAST type as obtained from their MRIs.
After the appropriate statistical analysis of our data we found that Total score of NIHSS and SPD-CAT (individually
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and combined) are found to have a highly significant correlation with the lesion volume percent to the whole brain volume. Right sided strokes are different from left sided and bilateral strokes of total and subscores of both NIHSS and SPD-CAT. Also the left to right ratio of ICWs in the picture description gives a significant difference between right and left sided strokes. It is also found that the pattern of scores of SPD may help in prediction of the lobar site of the stroke especially in the tempropariatel region and the brainstem. TOAST classification types are found to be correlated significantly with the lesion volume percent to the whole brain volume as well as to the scores of NIHSS and SPD-CAT.
from our study we concluded that by combined quantitative analysis of NIHSS and SPD-CAT either the total or subscores) we can better predict the site, size and side of acute ischemic stroke without added time or the need of MRI urgent processing to help in different assessment and management steps