How Is the NIH Stroke Scale Used for the Evaluation of Stroke? (2024)

FAQs

How Is the NIH Stroke Scale Used for the Evaluation of Stroke? ›

Health care providers use it to measure neurological function and deficits by asking the person to answer questions and perform several physical and mental tests. This checklist of questions and tasks scores a person's level of alertness and ability to communicate and perform simple movements.

The NIHSS score is defined as the sum of 15 individually evaluated elements, and ranges from 0 to 42. Stroke severity may be categorized as follows: no stroke symptoms, 0; minor stroke, 1–4; moderate stroke, 5–15; moderate to severe stroke, 16–20; and severe stroke, 21–42 [6, 7].

Conclusions: The NIHSS score strongly predicts the likelihood of a patient's recovery after stroke. A score of ≥16 forecasts a high probability of death or severe disability whereas a score of ≤6 forecasts a good recovery.

The NIH Stroke Scale (NIHSS) is a standardized scoring assessment used during a neurological exam after a stroke to measure aspects of brain function. The NIHSS is a standardized tool that measures and records the level of impairment caused by a stroke.

The National Institutes of Health Stroke Scale (NIHSS)

This stroke scale may be used to identify the likelihood of a stroke, and can also estimate severity. It measures 15 clinical functions or deficits such as gaze, vision, level of consciousness and facial palsy.

The NIHSS is a 15-item neurological examination stroke scale used to evaluate the effect of acute cerebral infarction on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss.

There are several imaging tests used to diagnose stroke. Computed tomography (CT) uses X-rays to take clear, detailed pictures of your brain. It is often done right after a suspected stroke. A brain CT scan can show whether there is bleeding in the brain or damage to the brain cells from a stroke.

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 and aid planning post-acute care disposition, though was intended to assess differences in interventions in clinical trials.

The ICC kappa value was 0.95 (95% CI, 0.93 - 0.97), indicating excellent reliability of NIHSS scoring between the ER and neurology teams.

NIHSS scores range from 0 to 42, with higher scores indicating more severe neurological deficit. The NIHSS has a high intraobserver and interobserver reliability after only a few hours of training, is easy and quick to assess, and is a valid measure of stroke severity.

What are the outcomes of the NIH Stroke Scale? ›

Outcomes related to NIHSS scores at admission: Scores of <5; 80% of stroke survivors will be discharged to home. Score between 6 and 13 typically require acute inpatient rehabilitation. Scores of >14 frequently require long-term skilled care.

Obtain full NIHSS scores a minimum of every 2 hours for the first 24 hours during reperfusion; after that obtain full NIHSS scores at least every 4 hours, increasing the time between assessments as dictated by changes in a patient's status.

The NIH scoring system uses a 9-point rating scale from 1 = Exceptional to 9 = Poor for the overall impact/priority score as well as the individual review criteria. Ratings are provided only in whole numbers, not decimals.

A score of <5 represents no stroke symptoms or a minor stroke, a score of 5 to 15 represents a moderate stroke, a score of 16 to 20 represents a moderate to severe stroke, and a score of 21 to 42 represents a severe stroke.

The Stroke Impact Scale (SIS) assesses other dimensions of health related quality of life: emotion, communication, memory and thinking, and social role function. *The first four of these domains may be combined into one physical domain, but the others must be scored separately.

In a systematic review of prehospital stroke scales performed by EMS providers in the field, both the CPSS (area under the curve, 0.813) and the Los Angeles Prehospital Stroke Screen (area under the curve, 0.964) showed better performance than five other field stroke recognition scales.

A score of <5 represents no stroke symptoms or a minor stroke, a score of 5 to 15 represents a moderate stroke, a score of 16 to 20 represents a moderate to severe stroke, and a score of 21 to 42 represents a severe 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.

Developed through research supported by NINDS, the widely used NIH Stroke Scale helps health care providers assess the severity of a stroke. Health care providers use it to measure neurological function and deficits by asking the person to answer questions and perform several physical and mental tests.

The Modified Rankin Score (mRS) is a 6 point disability scale with possible scores ranging from 0 to 5. A separate category of 6 is usually added for patients who expire. The Modified Rankin Score (mRS) is the most widely used outcome measure in stroke clinical trials.