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NIH Stroke Score
Criteria
Value
1A: Level of consciousness
Alert; keenly responsive (0)
Arouses to minor stimulation (+1)
Requires repeated stimulation to arouse (+2)
Movements to pain (+2)
Postures or unresponsive (+3)
1B: Ask month and age
Both questions right (0)
1 question right (+1)
0 questions right (+2)
Dysarthric/intubated/trauma/language barrier (+1)
Aphasic (+2)
1C: 'Blink eyes' & 'squeeze hands'
Performs both tasks (0)
Performs 1 task (+1)
Performs 0 tasks (+2)
2: Horizontal extraocular movements
Normal (0)
Partial gaze palsy: can be overcome (+1)
Partial gaze palsy: corrects with oculocephalic reflex (+1)
Forced gaze palsy: cannot be overcome (+2)
3: Visual fields
No visual loss (0)
Partial hemianopia (+1)
Complete hemianopia (+2)
Patient is bilaterally blind (+3)
Bilateral hemianopia (+3)
4: Facial palsy
Normal symmetry (0)
Minor paralysis (flat nasolabial fold, smile asymmetry) (+1)
Partial paralysis (lower face) (+2)
Unilateral complete paralysis (upper/lower face) (+3)
Bilateral complete paralysis (upper/lower face) (+3)
5A: Left arm motor drift
No drift for 10 seconds (0)
Drift, but doesn't hit bed (+1)
Drift, hits bed (+2)
Some effort against gravity (+2)
No effort against gravity (+3)
No movement (+4)
Amputation/joint fusion (0)
5B: Right arm motor drift
No drift for 10 seconds (0)
Drift, but doesn't hit bed (+1)
Drift, hits bed (+2)
Some effort against gravity (+2)
No effort against gravity (+3)
No movement (+4)
Amputation/joint fusion (0)
6A: Left leg motor drift
No drift for 5 seconds (0)
Drift, but doesn't hit bed (+1)
Drift, hits bed (+2)
Some effort against gravity (+2)
No effort against gravity (+3)
No movement (+4)
Amputation/joint fusion (0)
6B: Right leg motor drift
No drift for 5 seconds (0)
Drift, but doesn't hit bed (+1)
Drift, hits bed (+2)
Some effort against gravity (+2)
No effort against gravity (+3)
No movement (+4)
Amputation/joint fusion (0)
7: Limb Ataxia
No ataxia (0)
Ataxia in 1 Limb (+1)
Ataxia in 2 Limbs (+2)
Does not understand (0)
Paralyzed (0)
Amputation/joint fusion (0)
8: Sensation
Normal; no sensory loss (0)
Mild-moderate loss: less sharp/more dull (+1)
Mild-moderate loss: can sense being touched (+1)
Complete loss: cannot sense being touched at all (+2)
No response and quadriplegic (+2)
Coma/unresponsive (+2)
9: Language/aphasia
Normal; no aphasia (0)
Mild-moderate aphasia: some obvious changes, without significant limitation (+1)
Severe aphasia: fragmentary expression, inference needed, cannot identify materials (+2)
Mute/global aphasia: no usable speech/auditory comprehension (+3)
Coma/unresponsive (+3)
10: Dysarthria
Normal (0)
Mild-moderate dysarthria: slurring but can be understood (+1)
Severe dysarthria: unintelligible slurring or out of proportion to dysphasia (+2)
Mute/anarthric (+2)
Intubated/unable to test (0)
11: Extinction/inattention
No abnormality (0)
Visual/tactile/auditory/spatial/personal inattention (+1)
Extinction to bilateral simultaneous stimulation (+1)
Profound hemi-inattention (ex: does not recognize own hand) (+2)
Extinction to >1 modality (+2)
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