Neurology

NIHSS (Stroke Severity)

National Institutes of Health Stroke Scale.

Education and reference only. Not a substitute for clinical judgement, local policy or product labelling. Always verify before clinical use. Values are calculated in your browser and never stored.

When to use

Use to quantify the severity of an acute ischaemic stroke at presentation and over time, and to inform treatment decisions.

Why use

It standardises stroke assessment and correlates with outcome and treatment eligibility.

1a. Level of consciousness

1b. LOC questions (month, age)

1c. LOC commands (open eyes, grip)

2. Best gaze

3. Visual fields

4. Facial palsy

5a. Left arm motor

5b. Right arm motor

6a. Left leg motor

6b. Right leg motor

7. Limb ataxia

8. Sensory

9. Best language

10. Dysarthria

11. Extinction / inattention

Advice

Higher scores indicate more severe stroke and inform thrombolysis/thrombectomy decisions alongside imaging and time windows. Follow local stroke pathways.

Evidence & references

Brott T et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989.

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