Units: US SI

NIH Stroke Scale/Score (NIHSS)

Note: The NIH Stroke Scale requires that you understand the neurologic exam and has many caveats buried within it; if your patient has any prior known neurologic deficits (prior weakness, hemi- or quadriplegia, blindness, etc.), it becomes especially complicated; you should consult the NIH Stroke Scale website. MDCalc's version is an attempt to clarify many of these confusing caveats, but cannot be substituted for the official protocol.
1A: Level of Consciousness
(If intubated/difficult to assess, make best guess, but only choose 3 if posturing/unresponsive)		 0
1
2
2
3
1B: Ask Month and Age 0
1
2
1
2
1C: Tell Patient To Open and Close Eyes, then Hand Grip Squeeze
(Substitute/Pantomime Commands if Language Barrier/Confusion)		 0
1
2
2: Test Horizontal Extraocular Movements 0
1
1
2
3: Test Visual Fields 0
1
2
3
3
4: Test Facial Palsy
(Use Grimace if Obtunded)		 0
1
2
3
3
5A: Test Left Arm Motor Drift 0
1
2
2
3
4
Unable
5B: Test Right Arm Motor Drift 0
1
2
2
3
4
Unable
6A: Test Left Leg Motor Drift 0
1
2
2
3
4
Unable
6B: Test Right Leg Motor Drift 0
1
2
2
3
4
Unable
7: Test Limb Ataxia
(FNF/Heel-Shin)		 0
1
2
0
0
Unable
8: Test Sensation 0
1
1
2
2
2
9: Test Language/Aphasia
(Describe the scene; name the words; read the sentences.)
 0
1
2
3
3
10: Test Dysarthria
(Read the words.)
 0
1
2
2
UN
11: Test Extinction/Inattention 0
1
1
2
2
NIH Stroke Scale:
Remember, an NIH Stroke Scale of 0 does not mean the patient is not having a stroke! (Notorious for missing posterior circulation strokes.)

Posted in: Neurologic • Neurology • Uncategorized

Equations

Scores