NIH Stroke Scale
No matter how bad things are, they can always be worse. So what if my stroke left me with a speech impediment? Moses had one, and he did all right - Kirk Douglas
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Wikipedia
The National Institutes of Health Stroke Scale, or NIH Stroke Scale (NIHSS) is a tool used by healthcare providers to objectively quantify the impairment caused by a stroke. The NIHSS is composed of 11 items, each of which scores a specific ability between a 0 and 4. For each item, a score of 0 typically indicates normal function in that specific ability, while a higher score is indicative of some level of impairment. The individual scores from each item are summed in order to calculate a patient's total NIHSS score. The maximum possible score is 42, with the minimum score being a 0.
Featured
Optimal NIH Stroke Scale Score for Predicting Outcome
This study supplies evidence that an NIHSS score provides different prognoses according to infarct location. The authors suggest that a score of ≥6 for an infratentorial stroke may require more-aggressive treatment, beyond thrombolysis alone. Thrombectomy may be of value for select patients in this category. Validation of these findings and exploration of the effect of supratentorial laterality in other clinical trial data sets will be important.
Stroke Survivors Scoring Zero on the NIH Stroke Scale Score Still Exhibit Significant Motor Impairment and Functional Limitation
While being used in stroke trials, the NIHSS may have limited ability to discriminate between treatment responses, even when only a relatively narrow array of impairment levels exists among patients. Given these findings, NIHSS use should be restricted to acute stroke studies and clinical settings with the goal of reporting stroke severity.
Articles of Interest
What Is The NIH Stroke Scale (NIHSS)?
Generally, the scale is accurate and tends to predict damage/outcomes well. This is why we believe it’s important to give you an overview of the scale, how it works, what it means, and how to read it.
Resources
NIH Stroke Scale/Score (NIHSS)
Excellent resource for quick scoring of the NIH stroke scale.
MDCalc
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 and should not be substituted for the official protocol.
National Institute of Neurological Disorders and Stroke
Administer stroke scale items in the order listed. Record performance in each category after each subscale exam. Do not go back and change scores. Follow directions provided for each exam technique. Scores should reflect what the patient does, not what the clinician thinks the patient can do.
NIH Stroke Scale International
The NIH Stroke Scale (NIHSS) International is an initiative by national and international government entities as well as private and scholastic organizations. These bodies are dedicated to promoting wellness and better patient care in the field of stroke.
