VAN Assessment Calculator

VAN Assessment Calculator for Neurology. A positive screen suggests possible LVO; a negative screen does not exclude stroke or all occlusions. Neither result selects thrombolysis or thrombectomy.

For shared guidance on choosing a tool and documenting results, read the clinical calculator workflow.

How this calculator works

Test arm weakness first. With weakness present, any visual, aphasic or neglect finding makes VAN positive. This logical AND rule comes from the primary pilot: https://pmc.ncbi.nlm.nih.gov/articles/PMC5284468/

When to use this calculator

A rapid large-vessel occlusion screen during acute stroke assessment. The original study was a small pilot, not proof of perfect diagnostic accuracy: https://pubmed.ncbi.nlm.nih.gov/26891627/

Inputs used

  • Suspected acute stroke with reliable examination
  • Arm weakness on the initial arm-hold assessment
  • Visual disturbance, assessed only if weakness is present
  • Aphasia, assessed only if weakness is present
  • Neglect or forced gaze, assessed only if weakness is present

Clinical interpretation

A positive screen suggests possible LVO; a negative screen does not exclude stroke or all occlusions. Neither result selects thrombolysis or thrombectomy.

Worked example

Arm weakness plus aphasia is VAN positive. Aphasia and a visual deficit without arm weakness are VAN negative by this algorithm, but still warrant urgent stroke assessment.

Limitations and safety notes

Aphasia is a language deficit, not isolated dysarthria. Forced gaze is included under neglect. Sedation, old deficits and communication barriers affect reliability; unknown cortical findings cannot create a negative result when weakness is present.

Frequently asked questions

Can two cortical signs outweigh absent weakness?

No. VAN is not a summed severity score. Weakness is a required positive-screen condition.

References

  • Teleb et al. Original VAN pilot, published online 2016: https://pubmed.ncbi.nlm.nih.gov/26891627/
  • Full primary report; Table 1 and staged examination: https://pmc.ncbi.nlm.nih.gov/articles/PMC5284468/

Editorial review and citation methodology

Maintained by the Quick Medical Calculator Editorial Team. Content record date: September 9, 2026. A content date is not evidence of independent clinical review. Individual clinical sign-off is not recorded on this page.

  • Prefer original validation studies for scoring systems and prediction tools.
  • Use current specialty society guidance, transplant allocation policy, public health guidance, or regulator resources when they govern clinical use.
  • Include limitations and safety notes when a calculator is population-specific, context-dependent, or unsuitable as a standalone decision tool.

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