Lightning Learning: ROSIER Score
“The ROSIER score is used to distinguish between suspected stroke and stroke mimics.”
What?
ROSIER = Recognition Of Stroke In the Emergency Room
Has there been LOC or syncope?
Yes (-1)
No (0)
Has there been any seizure activity?
Yes (-1)
No (0)
Is there NEW ACUTE ONSET?
Asymmetrical facial weakness?
Yes (1)
No (0)
Asymmetrical arm weakness?
Yes (1)
No (0)
Asymmetrical leg weakness?
Yes (1)
No (0)
Speech disturbance?
Yes (1)
No (0)
Visual field defect?
Yes (1)
No (0)
Total Score: ______ (between -2 and +5)
Why?
It is used to distinguish between suspected stroke and stroke mimics.
Developed to achieve rapid diagnosis of suspected strokes to ensure patients are identified within the thrombolysis window as much as possible.
If score > 0 (stroke is likely)
If score </= 0 (stroke is unlikely but not completely excluded!)
Patients with suspected TIA (symptoms have resolved) should be assessed for risk of subsequent stroke using ABCD^2 score.
Further Reading
- EMed by Cork Emergency Medicine: ROSIER Online Tool
- NICE Guidance: Stroke and Transient Ischaemic Attack (TIA) in over 16s: diagnosis and initial management
