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NIHSS Comprehensive

Retrospective Validation (2025): If scoring from records, map GCS and MRC scales per Alamri et al. Assign 1 point each to items 9 and 10 for ambiguous "slurred speech" documentation.

1a: Consciousness0

1b: Orientation0

1c: Commands0

2: Horizontal Gaze0

3: Visual Fields0

4: Facial Palsy0

5a: L-Arm Motor0

5b: R-Arm Motor0

6a: L-Leg Motor0

6b: R-Leg Motor0

7: Limb Ataxia0

8: Sensory0

9: Language0

10: Dysarthria0

11: Extinction0

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Standard of Care

Baseline quantification of neurological deficit in Acute Ischemic Stroke (AIS).

Primary tool for reperfusion eligibility (IV Thrombolysis / Thrombectomy).

Validated for patient handoff between ER and Neurology teams (Cummock, 2023).

Predicts hospital disposition and 3-month functional outcomes (mRS).

Assessment Timing

Perform at T0 (presentation), 2h post-reperfusion, 24h post-onset, and at discharge. A change of ±4 points is clinically significant, often requiring repeat imaging to rule out hemorrhagic transformation.

Last Comprehensive Review: 2026

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In Recent Clinical News

Scanning Medical Journals

No new significant updates or guidelines matching this topic were found today. We will check again soon.