Data for: DEFENSIVE Stroke Scale: Novel Diagnostic Tool for Predicting Posterior Circulation Infarction in the Emergency Department
Dizziness, disequilibrium, a floating sensation, imbalance and vertigo are relatively common complaints in the emergency department. Although the most common posterior circulation symptom is dizziness, few stroke scales specialize in posterior circulation strokes. Furthermore, no systematic studies have investigated the misdiagnosis of posterior circulation infarctions. Here, we investigated the accuracy of the diagnosis of posterior circulation infarctions with dizziness in the emergency department and found that a posterior inferior cerebellar artery (PICA) territory infarction was not properly diagnosed in the emergency department, particularly in young subjects. Based on the results, we developed and validated a stroke recognition tool called the DEFENSIVE (DisEquilibrium, Floating sEnsation, Non-Specific dizziness, Imbalance and VErtigo) stroke scale to improve the diagnostic accuracy of stroke in subjects presenting to the emergency department with acute dizziness. As a result, no subject with ischemic stroke was overlooked in the emergency department after the introduction of the DEFENSIVE stroke scale. In addition, our approach was effective for subjects with false-negativity in the initial diffusion-weighted imaging (DWI) study. In summary, the DEFENSIVE stroke scale has good diagnostic accuracy and is simple to use in an emergency setting.