Neurology Book

Otolaryngology

Ophthalmology

Headache Disorders

Infectious Disease

Level of Consciousness

Motor Disorders

Sensory Disorders

Cognitive Disorders

Cerebellar Disorders

Cerebrospinal Fluid Disorders

Cardiovascular Medicine

Approach

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VAN Score

Aka: VAN Score, Stroke Vision Aphasia Neglect Assessment
  1. Indications
    1. Prehospital identification of suspected CVA patients with large vessel Occlusion
      1. Triage tool to transport directly to tertiary center for possible mechanical thrombectomy
  2. Criteria
    1. Major Criteria: Weakness (required)
      1. Patient holds up arms for 10 seconds
      2. Mild drift, severe focal weakness or paralysis
        1. Present: Evaluate minor criteria as below
        2. Absent (no focal weakness): Negative VAN Score; not consistent with large vessel Occlusion
    2. Minor Criteria (one of the following in addition to focal weakness)
      1. Visual disturbance or
      2. Aphasia or
      3. Neglect
  3. Interpretation
    1. Positive VAN Score: Consistent with Large Vessel Occlusion (LVO)
      1. Focal weakness AND visual disturbance, Aphasia or neglect
    2. Negative VAN Score (Not consistent with VLO)
      1. No focal weakness or negative for minor citeria
  4. Efficacy
    1. Original study (Teleb, 2017)
      1. Test Sensitivity: 100%
      2. Test Specificity: 90%
  5. References
    1. Teleb (2017) j neurointerv surg 9:122-126 [PubMed]

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