NIH Stroke Scale

Author: Michelle Lin, MD
Updated: 2/6/2010

Stroke Score, NIH Scale

Score

  • 0 (No stroke)
  • 1-4 (Minor stroke)
  • 5-15 (Moderate stroke)
  • 15-20 (Moderate to severe stroke)
  • 21-42 (Severe stroke)


National Institute of Health Stroke Scale score
1a. Level of consciousness
assessed while taking history
  • 0 = Alert; keenly responsive
  • 1 = Not alert, but arousable by minor stimulation
  • 2 = Not alert; requires repeated stimulation
  • 3 = Unresponsive or responds only with reflex
1b. Level of consciousness questions
What is the month?
What is your age?
  • 0 = Answers two questions correctly
  • 1 = Answers one question correctly
  • 2 = Answers neither question correctly
1c. Level of consciousness commands:
Open and close your eyes
Grip and release your hand
  • 0 = Performs both tasks correctly
  • 1 = Performs one task correctly
  • 2 = Performs neither task correctly
2. Best gaze
  • 0 = Normal
  • 1 = Partial gaze palsy
  • 2 = Forced deviation
3. Visual
  • 0 = No visual loss
  • 1 = Partial hemianopia
  • 2 = Complete hemianopia
  • 3 = Bilateral hemianopia
4. Facial palsy
Use grimmace if obtunded
  • 0 = Normal symmetric movements
  • 1 = Minor paralysis
  • 2 = Partial paralysis
  • 3 = Complete paralysis of one or both sides
5. Motor arm
5a. Left arm
5b. Right arm
  • 0 = No drift
  • 1 = Drift
  • 2 = Some effort against gravity
  • 3 = No effort against gravity
  • 4 = No movement
6. Motor leg
6a. Left leg
6b. Right leg
  • 0 = No drift
  • 1 = Drift
  • 2 = Some effort against gravity
  • 3 = No effort against gravity
  • 4 = No movement
7. Limb ataxia
  • 0 = Absent
  • 1 = Present in one limb
  • 2 = Present in two limbs
8. Sensory
  • 0 = Normal; no sensory loss
  • 1 = Mild-to-moderate sensory loss
  • 2 = Severe to total sensory loss
9. Best language
  • 0 = No aphasia; normal
  • 1 = Mild to moderate aphasia
  • 2 = Severe aphasia
  • 3 = Mute, global aphasia
10. Dysarthria
  • 0 = Normal
  • 1 = Mild to moderate dysarthria
  • 2 = Severe dysarthria
11. Extinction and inattention
  • 0 = No abnormality
  • 1 = Visual, tactile, auditory, spatial, or personal inattention
  • 2 = Profound hemi-inattention or extinction

Total score = 0-42

References

  1. "NINDS Know Stroke Campaign - NIH Stroke Scale". Stroke.nih.gov. N.p., 2017. Web. 24 Mar. 2017. [Source]