The SCAN rule: a clinical rule to reduce CT misdiagnosis of intracerebral haemorrhage in minor stroke

Many patients with minor stroke are referred to outpatient clinics and are not scanned immediately. A clinical rule is needed to identify patients who are likely to have intracerebral haemorrhage (ICH) and require urgent brain imaging and patients who can safely start antiplatelet agents before scanning.
"The SCAN rule" was designed to identify such patients as presentin  ≥1  of next factors: S) severe hypertension, (C) confusion, (A) anticoagulation, (N) nausea and vomiting.
This rule appears to be specific and sensitive at identifying ICH in an independent cohort of patients with minor stroke, although further independent validations are needed.

The SCAN rule

Expedite CT brain imaging or arrange MRI for late-presenting patients with minor stroke if one or more of the following are present on history taking or assessment:

(S) Severe hypertension at presentation: systolic blood pressure ≥80 mm Hg or diastolic blood pressure ≥110 mm Hg

(C) Confusion

(A) Anticoagulation use before stroke onset

(N) Nausea and vomiting

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