NIH Stroke Scale/Score (NIHSS)
The NIH Stroke Scale has many caveats buried within it. If your patient has prior known neurologic deficits e.g. prior weakness, hemi- or quadriplegia, blindness, etc. or is intubated, has a language barrier, etc., it becomes especially complicated. In those cases, consult the NIH Stroke Scale website. MDCalc's version is an attempt to clarify many of these confusing caveats, but cannot and should not be substituted for the official protocol.
- Score what you see, not what you think.
- Score the first response, not the best response (except Item 9 - Best Language).
- Don’t coach.