Quantitative Brain SPECT and the NIH Stroke Scale

To the Editor: The excellent article by Grotta and Alexandrov1 not only provides objective evidence in a small number of patients that intravenous tissue plasminogen activator (tPA) improves cerebral perfusion but also provides important data about the National Institutes of Health Stroke Scale (NIHSS) rating system. If the NIHSS score data from their article are plotted against the corresponding single-photon emission computed tomography (SPECT)-graded scale score, a relationship becomes apparent, as shown in the Figure⇓. If one omits the …