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Clinical Calculator
Neurology V1.0
NIHSS
Score
Stroke Severity Quantification — Guides Thrombolytic Eligibility
Primary Reference
Brott T, et al.
Stroke 1989; 20:864–870
Neurological Exam
1. 1a. Level of Consciousness
Alert (0)
Not alert, arousable (1)
Not alert, obtunded (2)
Unresponsive (3)
2. 1b. LOC Questions (month, age)
Both correct (0)
One correct (1)
Neither correct (2)
3. 1c. LOC Commands (open/close eyes, grip)
Both correct (0)
One correct (1)
Neither correct (2)
4. 2. Best Gaze
Normal (0)
Partial gaze palsy (1)
Forced deviation (2)
5. 3. Visual Fields
No visual loss (0)
Partial hemianopia (1)
Complete hemianopia (2)
Bilateral hemianopia (3)
6. 4. Facial Palsy
Normal (0)
Minor paralysis (1)
Partial paralysis (2)
Complete paralysis (3)
7. 5. Motor Arm (Left)
No drift (0)
Drift (1)
Some effort against gravity (2)
No effort against gravity (3)
No movement (4)
8. 6. Motor Arm (Right)
No drift (0)
Drift (1)
Some effort (2)
No effort (3)
No movement (4)
9. 7. Limb Ataxia
Absent (0)
Present in 1 limb (1)
Present in 2 limbs (2)
10. 8. Sensory
Normal (0)
Mild-moderate loss (1)
Severe or total loss (2)
11. 9. Best Language
No aphasia (0)
Mild-moderate aphasia (1)
Severe aphasia (2)
Mute / global aphasia (3)
12. 10. Dysarthria
Normal (0)
Mild-moderate (1)
Severe / mute (2)
13. 11. Extinction / Inattention
No abnormality (0)
One modality (1)
Profound (2)
Calculate NIHSS
Analysis Required
Enter patient parameters to calculate
stroke severity.
—
Points
Stroke Severity
—
—
Severity
—
Thrombolysis Guidance
—
Minor 0–4
Moderate 5–15
Severe ≥16
Breakdown
Clinical Implication
—
References & Original Research
↕ Hover to expand
1
Brott T, Adams HP Jr, Olinger CP, et al.
Measurements of acute cerebral infarction: a clinical examination scale.
Stroke 1989;20:864–870.
View ↗
2
Powers WJ, et al.
2019 AHA/ASA Guideline for Acute Ischemic Stroke Management.
Stroke 2019;50:e344–e418.
View ↗