NIH Stroke Scale

Score the National Institutes of Health Stroke Scale on its 15 items and return the total (0-42) plus the conventional severity band (minor 1-4, moderate 5-15, moderate-to-severe 16-20, severe >=21).

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

2 Best gaze
0
3 Visual fields
0
4 Facial palsy
1
5 Motor arm, sum of left + right
2
6 Motor leg, sum of left + right
0
7 Limb ataxia
0
8 Sensory
0
9 Best language
1
10 Dysarthria
0
11 Extinction and inattention
0
The other 3 values
1a Level of consciousness
1
1b LOC questions
0
1c LOC commands
0

Result: NIHSS total 5 (Moderate stroke).

The tool opens with these values already filled in. Replace them with your own.

What the result means

0
No stroke symptoms per NIH/NINDS interpretation guide.
1-4
Minor stroke per NIH/NINDS interpretation guide.
5-15
Moderate stroke per NIH/NINDS interpretation guide.
16-20
Moderate-to-severe stroke per NIH/NINDS interpretation guide.
21-42
Severe stroke per NIH/NINDS interpretation guide.

What you enter

  • 1a Level of consciousness (0-3)
  • 1b LOC questions (0-2)
  • 1c LOC commands (0-2)
  • 2 Best gaze (0-2)
  • 3 Visual fields (0-3)
  • 4 Facial palsy (0-3)
  • 5 Motor arm, sum of left + right (0-8)
  • 6 Motor leg, sum of left + right (0-8)
  • 7 Limb ataxia (0-2)
  • 8 Sensory (0-2)
The other 3 fields
  • 9 Best language (0-3)
  • 10 Dysarthria (0-2)
  • 11 Extinction and inattention (0-2)

What this is

Sophie Well presents the items in the standard administration order so the score can be entered as the exam progresses. NIHSS is a public-domain instrument maintained by NIH/NINDS.

When to use it

Use NIHSS for acute ischemic stroke assessment, eligibility decisions for IV thrombolysis and endovascular therapy, and serial monitoring. NIHSS under-detects posterior-circulation strokes and is operator-dependent; certification is the standard. A normal NIHSS does not rule out stroke, and the score is one input into reperfusion decisions, not a substitute for the imaging and time-of-onset workup.

How this is calculated

Brott T, Adams HP Jr, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864-870. Public-domain instrument maintained by NIH/NINDS. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.