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NIHSS — Stroke Scale

National Institutes of Health Stroke Scale. 15 items, 0–42 points. Document at presentation, post-tPA, and at 24 h.

Total = sum of all items (0 to 42)
1a. Level of consciousness
— / 3
1b. LOC Questions (month, age)
— / 2
1c. LOC Commands (open/close eyes, grip)
— / 2
2. Best gaze
— / 2
3. Visual fields
— / 3
4. Facial palsy
— / 3
5a. Motor arm — LEFT
— / 4
5b. Motor arm — RIGHT
— / 4
6a. Motor leg — LEFT
— / 4
6b. Motor leg — RIGHT
— / 4
7. Limb ataxia
— / 2
8. Sensory
— / 2
9. Best language
— / 3
10. Dysarthria
— / 2
11. Extinction / inattention
— / 2
Total NIHSS
0/ 42 · 0/15 answered
Severity
0 No stroke symptoms 1–4 Minor stroke 5–15 Moderate stroke 16–20 Moderate–severe stroke 21–42 Severe stroke
Use total NIHSS together with clinical judgement, time-of-onset, and imaging when considering thrombolysis or thrombectomy.

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