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Abstract Details

Positive HANG score predicts large vessel occlusion or severe stenosis in anterior circulation stroke
Cerebrovascular Disease and Interventional Neurology
P9 - Poster Session 9 (12:00 PM-1:00 PM)
4-019
To study the correlation between HANG score and presence of large vessel occlusion (LVO) or Large vessel  stenosis (LVS > 70%) in acute stroke.
EMS providers need to identify and preferentially transport patients experiencing large vessel occlusion stroke to appropriate treatment centers.  Currently available pre-hospital LVO detection tools are insensitive delaying appropriate treatment. High NIH stroke scale >8 is considered suggestive of LVO.
Retrospective chart review of 285 acute stroke patients from January 2017-September, 2019 including NIHSS and CTA Head and neck, 175 patients were included.  Patient with vertebrobasilar artery stroke were excluded.  CT scans ware reviewed for gaze deviation.  Patients were assessed for Hemianopia, Aphasia, Neglect, Gaze (HANG) and scored from 0-absent and 1- present to make it simple in the field assessment.
60/75 patients with acute stroke, NIH stroke scale >2 and LVO/LVS showed HANG≥1.  Patient with stroke due to Internal carotid artery  stenosis/thrombus (9) and ACA stroke (1) has poor correlation.  Patient with distal thrombus(M3) had poor correlation (2/75).  Right gaze deviation and neglect were seen in 24/25 Right middle cerebral artery( RMCA)  stroke while aphasia was most common finding in Left Middle cerebral artery stroke (33/38).  Out of 100 patients with acute stroke in the anterior circulation  & no  LVO/LVS and  NIH stroke scale more than 6, HANG score was 0.
HANG score is simple and sensitive tool to identify LVO/LVS by field EMS and triage nurse in ER derived from  well known NIH stroke scale .  This score is very sensitive, 96 percent for RMCA stroke due to  thrombus/severe stenosis  and  86.84 percent due to  left MCA thrombus/stenosis .  Though the sample size is small, HANG score of 0 correlated with no large vessel occlusion in MCA distribution irrespective of  NIH stroke scale .  Gaze deviation to the right with hyperdense  MCA sign was pathognomonic for right MCA clot. 
Authors/Disclosures
Harsh Singh
PRESENTER 		No disclosure on file
Ashish Nanda, MD (SSM health Neurosciences) No disclosure on file
Vikas Kumar, MD, FÂ鶹´«Ã½Ó³»­ (SSM Neuroscience Institute) Dr. Kumar has nothing to disclose.
No disclosure on file