Neurology Book

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NIH Stroke Scale

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  1. See Also
    1. Cerebrovascular Accident
  2. Criteria
    1. Assess Level of Consciousness (Alert=0, Coma=3)
    2. Assess Orientation: Month, Age (1 point per bad answer)
    3. Follow Commands (1 point per command NOT obeyed)
      1. Open and close eyes
      2. Make fist and release
    4. Follow my finger (Normal=0, Forced deviation=2)
    5. Visual field (0=Normal, 2=hemianopia, 3=bilateral loss)
    6. Facial palsy (0=Normal, 3=Complete)
      1. Show teeth
      2. Raise eyebrows
      3. Squeeze eyes shut
    7. Motor Strength for each of 4 limbs
      1. Grading
        1. No drift: 0
        2. Unable to resist gravity: 2
        3. No movement: 4
        4. Amputation or fused joint: 9
      2. Limbs (passively move extremity and observe strength)
        1. Elevate left arm to 90 degrees
        2. Elevate right arm to 90 degrees
        3. Elevate left leg to 30 degrees
    8. Coordination or limb ataxia (Absent=0, both limbs=2)
      1. Finger-nose-finger
      2. Heel-knee-shin
    9. Sensory (Normal=0, Sever loss=2)
      1. Pin prick to face, arm, trunk, and legs
      2. Compare sides
    10. Language (No Aphasia=0, Mute=3)
      1. Name items
      2. Describe picture
      3. Read sentences
    11. Speech clarity while reading word list: Grading
      1. Normal articulation: 0
      2. Nearly unintelligible: 2
      3. Intubated or other physical barrier: 9
    12. Extinction and Inattention (None=0, Complete=2)
  3. Reference
    1. Spilker (2000) Stroke Intervent 2:7-14
    2. http://www.stroke-site.org
    3. (2000) Circulation 102(suppl I):I

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