National Institutes of Health Stroke Scale

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National Institutes of Health Stroke Scale
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Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Stroke severity
Complications
Onset
Duration
Types
Causes
Risks
Diagnosis Clinical assessment
Differential diagnosis N/A
Prevention N/A
Treatment
Medication N/A
Prognosis
Frequency
Deaths N/A


The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. It is used to evaluate the severity of a stroke and to determine appropriate treatment and prognosis.

History

The NIHSS was developed in the 1980s by a group of neurologists led by Dr. Patrick Lyden and Dr. Thomas Brott. It was designed to be a simple, reliable, and standardized method for assessing the neurological status of patients with acute stroke.

Components

The NIHSS consists of 11 items, each of which scores a specific ability between a 0 and 4. The individual scores are summed to calculate a patient's total NIHSS score, which can range from 0 to 42. The items include:

  1. Level of consciousness
  2. Best gaze
  3. Visual fields
  4. Facial palsy
  5. Motor arm
  6. Motor leg
  7. Limb ataxia
  8. Sensory
  9. Best language
  10. Dysarthria
  11. Extinction and inattention (formerly "neglect")

Scoring

The total NIHSS score helps to determine the severity of the stroke:

  • 0: No stroke symptoms
  • 1-4: Minor stroke
  • 5-15: Moderate stroke
  • 16-20: Moderate to severe stroke
  • 21-42: Severe stroke

Clinical Use

The NIHSS is widely used in both clinical practice and research. It is a critical tool in the initial assessment of stroke patients and is used to monitor changes in their condition over time. The scale is also used in clinical trials to assess the efficacy of stroke treatments.

Training and Certification

Healthcare professionals who use the NIHSS are typically required to undergo training and certification to ensure accurate and consistent scoring. This training is often available online and includes video demonstrations and practice cases.

Limitations

While the NIHSS is a valuable tool, it has limitations. It may not fully capture deficits in certain areas, such as cognitive function or subtle language impairments. Additionally, the scale may be less accurate in patients with pre-existing neurological conditions.

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Contributors: Kondreddy Naveen, Prab R. Tumpati, MD