NIH Stroke Scale (NIHSS)

Quantifies stroke severity across 15 neurological examination items. A score of 0 indicates no stroke symptoms; higher scores indicate greater severity.

NIHSS 0 /42 0/15

NIHSS

0 / 42

Answer all questions for interpretation

0/15

1 1A: Level of Consciousness

0 Alert; keenly responsive

1 Arouses to minor stimulation

2 Requires repeated stimulation to arouse

3 Postures or unresponsive

2 1B: LOC Questions (month and age)

0 Both questions correct

1 One question correct

2 Zero questions correct

3 1C: LOC Commands (blink eyes, squeeze hands)

0 Performs both tasks

1 Performs one task

2 Performs zero tasks

4 2: Horizontal Eye Movements

0 Normal

1 Partial gaze palsy

2 Forced gaze palsy

5 3: Visual Fields

0 No visual loss

1 Partial hemianopia

2 Complete hemianopia

3 Bilateral hemianopia

6 4: Facial Palsy

0 Normal symmetry

1 Minor paralysis

2 Partial paralysis

3 Complete paralysis

7 5A: Left Arm Motor Drift

0 No drift for 10 seconds

1 Drift but doesn't hit bed

2 Some effort against gravity

3 No effort against gravity

4 No movement

8 5B: Right Arm Motor Drift

0 No drift for 10 seconds

1 Drift but doesn't hit bed

2 Some effort against gravity

3 No effort against gravity

4 No movement

9 6A: Left Leg Motor Drift

0 No drift for 5 seconds

1 Drift but doesn't hit bed

2 Some effort against gravity

3 No effort against gravity

4 No movement

10 6B: Right Leg Motor Drift

0 No drift for 5 seconds

1 Drift but doesn't hit bed

2 Some effort against gravity

3 No effort against gravity

4 No movement

11 7: Limb Ataxia

0 No ataxia

1 Ataxia in one limb

2 Ataxia in two limbs

12 8: Sensory

0 Normal; no sensory loss

1 Mild-moderate sensory loss

2 Complete sensory loss

13 9: Language/Aphasia

0 Normal; no aphasia

1 Mild-moderate aphasia

2 Severe aphasia

3 Mute/global aphasia

14 10: Dysarthria

0 Normal

1 Mild-moderate dysarthria

2 Severe dysarthria/mute

15 11: Extinction/Inattention

0 No abnormality

1 Inattention in one modality

2 Profound hemi-inattention or extinction in more than one modality

Reference: Brott T, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864-870.