Table 1.

Updated (2012) and Former (2011) VARC Stroke Definitions5,51

Diagnostic Criteria
Acute episode of a focal or global neurological deficit with ≥1 of the following: change in the level of consciousness, hemiplegia, hemiparesis, numbness or sensory loss affecting one side of the body, dysphasia or aphasia, hemianopia, amaurosis fugax, or other neurological signs or symptoms consistent with stroke.
Stroke: Duration of a focal or global neurological deficit ≥24 hours; OR <24 hours if available neuroimaging documents a new hemorrhage or infarct; OR the neurological deficit results in death.
TIA: Duration of a focal or global neurological deficit <24 hours; any variable neuroimaging does not demonstrate a new hemorrhage or infarct.
No other readily identifiable nonstroke cause for the clinical presentation (eg, brain tumor, trauma, infection, hypoglycemia, peripheral lesion, pharmacological influences) to be determined by or in conjugation with the designated neurologist.
Confirmation of the diagnosis by ≥1 of the following:
Neurologist or neurosurgical specialist
Neuroimaging technique (CT scan or brain MRI), but stroke may be diagnosed on clinical grounds alone.
Stroke Definitions (VARC 2012)
Disabling stroke: An mRS score of ≥2 at 90 days and an increase in ≥1 mRS category from an individual's prestroke baseline.
Nondisabling stroke: An mRS score of 2 at 90 days or one that does not result in an increase in ≥1 mRS category from an individual's prestroke baseline.
Former Stroke Definitions (VARC 2011)
TIA:
New focal neurological deficit with rapid symptom resolution (usually 1–2 hours), always within 24 hours.
Neuroimaging without tissue injury
Stroke (diagnosis as above, preferably with positive neuroimaging study):
Minor: mRS score of 2 at 30 and 90 daysb
Major: mRS score ≥2 at 30 and 90 days

Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging; mRS, modified Rankin Scale; TIA, transient ischemic attack; VARC, Valve Academic Research Consortium.

^aPatients with nonfocal global encephalopathy will not be reported as having a stroke without unequivocal evidence based on neuroimaging studies.

^bModified Rankin Score assessments should be made by qualified individuals according to a certification process. If there is discordance between the 30‐day and 90‐day modified Rankin Scores, a final determination of major vs minor stroke will be adjudicated by the neurology members of the clinical events committee.