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ASTRAL Score for Ischemic Stroke

Emergency medicineBeta toolThis tool is in beta. It has undergone internal validation but still requires additional testing. Always confirm the data entered and the results obtained before clinical use. It should not be used as the sole basis for clinical decisions.

Completed years; the score assigns 1 point per 5 years.

years

Admission National Institutes of Health Stroke Scale score.

points

Adds 2 points only when the time is greater than 3 hours.

hours

Glucose value in the selected unit.

New visual field defectIndicate whether a stroke-related visual field deficit is present.
Impaired consciousnessIndicate whether consciousness is impaired at admission.

Clinical noticeUse this score to support clinical assessment; it does not replace diagnosis, individualized prognosis, or treatment decisions.

Context and use

Method

ASTRAL = floor(age / 5) + NIHSS + 2 if admission is >3 hours after onset/last known well + 2 for a new visual field defect + 1 for abnormal glucose + 3 for impaired consciousness.

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