Assessment Tool: NIH Stroke Scale (NIHSS)

Score all 15 items in sequence. NIHSS certification training is strongly recommended for accurate administration. Document onset time and last known well when completing this assessment.

NIH Stroke Scale (NIHSS)

A 15-item quantitative measure of stroke-related neurological deficit. Total score 0–42. Higher scores indicate greater severity. Developed by the National Institutes of Health; in the public domain. Certification training is strongly recommended for accurate administration.

NIHSS severity guide

0

No stroke

1–4

Minor

5–15

Moderate

16–20

Mod–severe

21–42

Severe

1a. Level of Consciousness
1b. LOC Questions (month and age)
1c. LOC Commands (blink eyes, grip and release)
2. Best Gaze
3. Visual Fields
4. Facial Palsy
5a. Motor Arm – Left
5b. Motor Arm – Right
6a. Motor Leg – Left
6b. Motor Leg – Right
7. Limb Ataxia
8. Sensory
9. Best Language
10. Dysarthria
11. Extinction and Inattention