The National Institutes of Health Stroke Scale (NIHSS) is a standardized method for quantifiable assessment of stroke symptoms. It is the preferred scoring system, and scores range from 0 to 42. A patient with a higher score on this scale is more likely to be considered disabled; however, the definition of "disabling" depends on age, occupation, underlying life-limiting comorbidities, advance directives. The crucial step in the evaluation of stroke patients is to obtain brain imaging to ascertain the type and characteristics of the stroke. In this regard, non-contrast CT of the head is the imaging modality of choice. Ischemic changes may classify as acute, subacute, and chronic, depending on the time in which they present after the onset of stroke. CT scan can also rule out intracranial hemorrhage. [18] If an intracranial hemorrhage is present, aneurysmal rupture should be investigated given its association with arterial vasospasm resulting in stroke. [3] Anterior cerebral artery strokes could be missed on imaging studies depending on their location or size. One case series found that 37.5% (6 of 16) of ACA infarcts evaluated by CT were identifiable only after using contrast injection or angiography. If the area of hypodensity is small and localized over a sulcus, the infarct could be overlooked. [1] [13]  Noncontrast head CT should be quickly followed by CT angiography of the head and neck to expedite identification of intracranial large vessel occlusion.
Chattem, Inc. is an American, Chattanooga, Tennessee-based, producer and marketer of over-the-counter healthcare products, toiletries, dietary supplements, topical analgesics, and medicated skin care products. Originally named the Chattanooga Medicine Company, the company’s brand portfolio holds twenty-two brands including Allegra, Gold Bond, Flexall, IcyHot, Rolaids, Sun-In, Pamprin, Dexatrim, Aspercreme, and Selsun Blue. The company produces two-thirds of its products at its Chattanooga production facilities with the remaining produced by third-party producers. The company is a subsidiary of the French multinational pharmaceutical company Sanofi. The company’s brands are sold nationally through mass merchandiser, drug and food retailers. In 2005, 70% of the firms sales were made through its top ten customers, which include Wal-Mart, Walgreens, and Kroger. Sales to Wal-Mart constituted 36% of Chattem’s total sales in 2005. Chattem supports these sales with a forty-five-person sales force and broadcast media advertising. Chattem has market penetration in the United States, Europe, Canada, Latin America, and the Caribbean. History
Chattem was founded by Zeboim Cartter Patten as the Chattanooga Medicine Company in 1879. The company incorporated in 1909 and has remained in Chattanooga, Tennessee, to this day. During World War II, the Chattanooga Medicine Company turned into a major supplier of K-Rations to the US Army, producing 34 million rations from 1942 to 1945, earning 5 "E" Awards for support of war efforts. The firm adopted Chattem as its name and went public in 1969. Chattem’s top and bottom lines grew significantly from 1989 through 1992.