A comparison of a standard neurological assessment tool to a stroke scale for detecting symptomatic cerebral vasospasm

Thumbnail Image
Doerksen, Kathryn J.
Journal Title
Journal ISSN
Volume Title
One of the primary causes of disability and death in individuals who have experienced a subarachnoid hemorrhage due to an aneurysm rupture is cerebral vasospasm. Vasospasm can cause a general decrease in the level of consciousness or the onset of focal deficit such as hemiplegia or aphasia. Early detection of vasospasm is critical in allowing prompt intervention and treatment to prevent further ischemia or infarction. The nurses role in observing and detecting changes in these critically ill patients was guided by the Nursing Model of Hospitalization Events (Smith, 1998). The research study consisted of comparing two assessment tools for quantitative data analysis of early detection of symptomatic vasospasm. The standard neurological record that is currently used was compared to the stroke scale developed by the National Institute of Neurological Disorders, and Stroke, and the National Institute of Health. The methodology was also comprised of a qualitative component using content analysis of the nurses' notes to enhance information regarding the patients' neurological status. There was no statistical significance demonstrated between the vasospasm and non-vasopasm groups, however several clinically relevant findings were shown. In particular the assessment of focal symptoms such as motor power will be discussed. Observations by the nurses regarding generalized changes in neurological status revealed findings such as restlessness, impulsiveness, and unusual behaviors are highlighted and provide evidence for future investigation. All findings and their relevance to the nurse's role in detecting symptomatic vasospasm will be discussed.