Transcription of NIH Stroke Scale
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NIH Stroke Scale
NIH Stroke ScaleAdminister Stroke Scale items in the order listed. Record performance in each category after each subscale exam. Do not go back and change scores. Follow directions provided for each exam technique. Scores should reflectwhat the patient does, not what the clinician thinks the patient can do. The clinician should record answers whileadministering the exam and work where indicated, the patient should not be coached ( , repeatedrequests to patient to make a special effort).InstructionsLevel of Consciousness: The investigator must choose a response if a full evaluation is prevented by such obstacles as an endotracheal tube, languagebarrier, orotracheal trauma/bandages. A 3 isscored only if the patient makes no movement(other than reflexive posturing) in response tonoxious Definition Level of Consciousness0 Alert;keenly alert;but arousable by minor stimulation to obey, answer, or alert; requires repeated stimulation to attend, or is obtunded and requires strong or painful stimulation to make movements (not stereotyped).
Scale Definition Limb Ataxia 0 Absent. 1 Present in one limb. 2 Present in two limbs. Amputation or joint fusion, explain: 7 Scale Definition Instructions Score 6a 6b Score Score Left Leg Right Leg 0 No drift; leg holds 30-degree position for full 5 seconds. 1 Drift; leg falls by the end of the 5-second period but does not hit the bed.
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