NIHSS calculator

NIH Stroke Scale (NIHSS)

NIH Stroke Scale (NIHSS)
Category Select Score
1a. Level of Consciousness 1 Alert (0)   Not alert, arousable (1)   Not alert, obtunded (2)   Unresponsive (3)
1b. LOC Questions (month, age) 1 Both correct (0)   One correct (1)   Neither correct (2)
1c. LOC Commands (open/close eyes, grip/release) 1 Both correct (0)   One correct (1)   Neither correct (2)
2. Best Gaze (horizontal) 1 Normal (0)   Partial gaze palsy (1)   Forced deviation (2)
3. Visual (visual fields) 1 No visual loss (0)   Partial hemianopia (1)   Complete hemianopia (2)   Bilateral hemianopia (3)
4. Facial Palsy 1 Normal (0)   Minor paralysis (1)   Partial paralysis (2)   Complete paralysis (3)
5a. Motor Arm — Left (drift) 1 No drift (0)   Drift (1)   Some effort against gravity (2)   No effort against gravity (3)   No movement (4)
5b. Motor Arm — Right 1 No drift (0)   Drift (1)   Some effort against gravity (2)   No effort against gravity (3)   No movement (4)
6a. Motor Leg — Left 1 No drift (0)   Drift (1)   Some effort against gravity (2)   No effort against gravity (3)   No movement (4)
6b. Motor Leg — Right 1 No drift (0)   Drift (1)   Some effort against gravity (2)   No effort against gravity (3)   No movement (4)
7. Limb Ataxia 1 Absent (0)   Present in one limb (1)   Present in two limbs (2)
8. Sensory 1 Normal (0)   Mild-moderate loss (1)   Severe/total loss (2)
9. Best Language 1 No aphasia (0)   Mild-moderate aphasia (1)   Severe aphasia (2)   Mute/global aphasia (3)
10. Dysarthria 1 Normal (0)   Mild-moderate (1)   Severe/mute (2)
11. Extinction/Inattention 1 No abnormality (0)   Inattention to one modality (1)   Profound neglect (2)
NIHSS Total / 42
Interpretation
0 No stroke symptoms.
1–4 Minor stroke.
5–15 Moderate stroke.
16–20 Moderate-severe stroke.
21–42 Severe stroke.
References
  • Brott T, Adams HP Jr, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864-870. PMID 2749846.
  • Lyden P, et al. NIHSS Training and Certification Using a Reliable Web-Based Tool. Stroke. 2009;40(8):2507-2511.
  • Note: NIHSS ≥6 is commonly used threshold for thrombolytic eligibility consideration.

References

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