NIH Stroke Score

 

Level of Consciousness
		Alert (0 points)
		Not alert, but arousable with minimal stimulation (1 point)
		Not alert, requires repeated stimulation to attend (2 points)
		Coma (3 points)
Patient Knows Month and Own Age
		Answers both correctly (0 points)
		Answers one correctly (1 point)
		Both incorrect (2 points)
Patient Opens and Close Eyes on Command
		Obeys both correctly (0 points)
		Obeys one correctly (1 point)
		Both incorrect (2 points)
Best Gaze (only horizontal eye movement)
		Normal (0 points)
		Partial gaze palsy (1 point)
		Forced deviation (2 points)
Visual Field testing
		No visual field loss (0 points)
		Partial hemianopia (1 point)
		Complete hemianopia (2 points)
		Bilateral hemianopia (blind including cortical blindness) (3 points)
Facial Paresis (Ask patient to show teeth or raise eyebrows and close eye
		Normal symmetrical movement (0 points)
		Minor paralysis (1 point)
		Partial paralysis (total or near total paralysis of lower face) (2 points)
		Complete paralysis of one or both sides (3 points)
Motor Function of Right Arm
		Normal (0 points)
		Drift (1 point)
		Some effort against gravity (2 points)
		No effort against gravity (3 points)
		No movement (4 points)
		Untestable* (0 points)
Motor Function of Left Arm
		Normal (0 points)
		Drift (1 point)
		Some effort against gravity (2 points)
		No effort against gravity (3 points)
		No movement (4 points)
		Untestable* (0 points)
Motor Function of Right Leg
		Normal (0 points)
		Drift (1 point)
		Some effort against gravity (2 points)
		No effort against gravity (3 points)
		No movement (4 points)
		Untestable* (0 points)
Motor Function of Left Leg
		Normal (0 points)
		Drift (1 point)
		Some effort against gravity (2 points)
		No effort against gravity (3 points)
		No movement (4 points)
		Untestable* (0 points)
Limb Ataxia
		None (0 points)
		One limb (1 point)
		Two Limbs (2 points)
Sensory by Pinprick
		Normal (0 points)
		Mild to moderate decrease in sensation (1 point)
		Severe to total sensory loss (2 points)
Language
		No aphasia (0 points)
		Mild - Moderate aphasia (1 point)
		Severe aphasia (2 points)
		No speech production (3 points)
Dysarthria
		None (0 points)
		Mild - Moderate slurring (1 point)
		Severe (2 points)
		Intubated or other physical impediment to testing (0 points)
Extinction and Inattention
		Normal (0 points)
		Inattention or extinction to bilateral simultaneous stimulation in one of the sensory modalities (1 point)
		Severe hemi-inattention or hemi-inattention to more than one modality (2 points)

 

Total Criteria Point Count:
 

Notes

• * If an arm or leg cannot be tested due to amputation or other limitation, untestable is recorded and no points are counted.
• NIH Stroke scores >22 are considered very significant and may predict increased complication risk.
• The score is commonly used to track outcomes, improvement or deterioration of a stroke.

 

References

1. Brott T, Adams HP Jr, Olinger CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989 Jul;20(7):864-70. PubMed ID: 2749846