Illustration of a brain with highlighted arteries and a SAVE scale checklist

Is It a Stroke? The SAVE Scale Could Help Spot Large Vessel Occlusions Faster

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"A new, simple clinical scale called SAVE shows promise in quickly identifying large vessel occlusions, potentially speeding up critical stroke treatment."

When it comes to stroke, every second counts. Quickly identifying the type of stroke a patient is experiencing is crucial for effective treatment. A large vessel occlusion (LVO), where a major artery in the brain is blocked, requires swift intervention to prevent severe and lasting damage. That’s why researchers are constantly seeking better, faster ways to recognize LVOs.

Traditionally, doctors have used complex clinical scales to assess stroke patients, but these can be time-consuming and require specialized training. Now, a new study suggests a simpler approach might be just as effective. Researchers have developed a streamlined tool called the Speech Arm Vision Eyes (SAVE) scale, and early results are promising.

This article explores how the SAVE scale works, its potential benefits, and what it could mean for the future of stroke care, particularly for women and younger adults seeking prompt diagnosis and treatment.

Decoding the SAVE Scale: Simplicity Meets Accuracy in Stroke Prediction

Illustration of a brain with highlighted arteries and a SAVE scale checklist

The SAVE scale focuses on four key areas: Speech, Arm strength, Vision, and Eye movements. Unlike more detailed assessments, SAVE uses binary scoring – meaning each area is simply marked as either 'normal' or 'abnormal.' This simplicity is by design, aiming to reduce the time and complexity associated with traditional stroke scales.

Researchers tested the SAVE scale in a retrospective analysis, drawing data from the Screening Technology and Outcomes Project in Stroke (STOPStroke) study. They assessed how well SAVE could predict LVOs compared to other established scales, including the NIHSS (National Institutes of Health Stroke Scale) and FAST-ED.

Speech: Is there any aphasia (difficulty understanding or expressing speech) or dysarthria (slurred speech)?
Arm: Is there any asymmetric arm weakness (difference in strength between the two arms) or drift?
Vision: Is there any hemianopia (loss of vision in half of the visual field) or quadrantanopia (loss of vision in a quarter of the visual field)?
Eyes: Is there any gaze preference (tendency to look to one side), forced gaze deviation, or abnormal horizontal eye movements?

The study revealed that the SAVE scale performed remarkably well. It had an area under the curve (AUC) of 0.79, comparable to the more complex mNIHSS (0.80) and FAST-ED (0.82). This indicates that SAVE can accurately discriminate between patients with and without LVOs.

The Future of Stroke Assessment: Wider Application of SAVE?

The SAVE scale offers a promising avenue for faster, simpler stroke assessment, potentially leading to quicker treatment and improved outcomes, especially for younger individuals and women. Further research is needed to validate these findings in different settings and populations. If the SAVE scale holds up, it could become a valuable tool for paramedics and emergency room staff, ensuring that more stroke patients get the right treatment, right away.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/neurintsurg-2018-014482, Alternate LINK

Title: The Speech Arm Vision Eyes (Save) Scale Predicts Large Vessel Occlusion Stroke As Well As More Complicated Scales

Subject: Neurology (clinical)

Journal: Journal of NeuroInterventional Surgery

Publisher: BMJ

Authors: Kevin J Keenan, Wade S Smith

Published: 2018-12-04

Everything You Need To Know

What is the Speech Arm Vision Eyes (SAVE) scale?

The Speech Arm Vision Eyes (SAVE) scale is a clinical tool designed to quickly identify potential large vessel occlusions (LVOs) in stroke patients. It focuses on assessing Speech, Arm strength, Vision, and Eye movements, with each area scored as either 'normal' or 'abnormal.' This simplicity aims to accelerate stroke assessment compared to more complex methods.

Why is the Speech Arm Vision Eyes (SAVE) scale important in stroke care?

The SAVE scale is important because rapidly identifying a large vessel occlusion (LVO) is crucial for effective stroke treatment. LVOs, where a major brain artery is blocked, require immediate intervention to minimize lasting damage. The SAVE scale's simplicity and speed could lead to quicker treatment and improved patient outcomes, especially for women and younger adults.

What specific things are evaluated when using the Speech Arm Vision Eyes (SAVE) scale?

The SAVE scale assesses Speech by checking for aphasia (difficulty understanding or expressing speech) or dysarthria (slurred speech). Arm strength is evaluated for asymmetric weakness or drift. Vision is assessed for hemianopia (vision loss in half of the visual field) or quadrantanopia (loss of vision in a quarter of the visual field). Eye movements are checked for gaze preference, forced gaze deviation, or abnormal horizontal movements.

Are there other stroke assessment scales besides the Speech Arm Vision Eyes (SAVE) scale?

The National Institutes of Health Stroke Scale (NIHSS) and FAST-ED are other established scales used to assess stroke patients. The study mentioned found that the SAVE scale performed comparably to these more complex scales in predicting large vessel occlusions (LVOs). This suggests that the SAVE scale could be a valuable alternative for faster initial assessments.

What does the area under the curve (AUC) tell us about the Speech Arm Vision Eyes (SAVE) scale's effectiveness?

The area under the curve (AUC) is a measure of how well a diagnostic test can distinguish between patients with and without a particular condition. In the study, the SAVE scale had an AUC of 0.79, similar to the mNIHSS (0.80) and FAST-ED (0.82). This indicates that the SAVE scale is accurate in identifying patients with large vessel occlusions (LVOs).