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The NIHSS (National Institute of Health Stroke Scale) - Oren Zarif - Nih Stroke Scale

Writer's picture: Oren ZarifOren Zarif

The NIHSS (National Institute of Health Stroke Scale) is a standardized scoring system used by healthcare professionals to gauge the severity of a patient's stroke. When a clot or rupture in the blood vessels block blood flow to the brain, the resulting lack of oxygen and nutrients will damage brain tissue, ultimately causing a handicap. The NIHSS also captures the side of the infarct.

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The NIH stroke scale is a valuable tool in assessing the severity of a stroke. It requires less than 10 minutes for skilled users and provides a solid baseline for assessment of stroke treatment. While the scale is not a perfect substitute for the official protocol, it can be helpful in predicting stroke symptoms. If the NIHSS is used in the right situation, it can help to guide a doctor's care.

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Recent research has shown that the NIHSS score significantly predicts outcome. Adding one point to the score decreased the likelihood of achieving an excellent outcome by up to 24%. Those with a NIHSS score between seven and 15 were more likely to reach an excellent outcome. However, the NIHSS has some limitations. Some studies have failed to report on the NIHSS score's accuracy.

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In a study by Fischer et al., the NIHSS score of 226 stroke patients was examined. Patients with a score of ten or higher were statistically more likely to experience arterial occlusion. Similarly, patients with a score of 12 or higher had a 91% positive predictive value for central occlusion. Interestingly, patients with a NIHSS score between six and twelve had a lower chance of dying within three months.

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The NIHSS was originally designed to assess differences between clinical trial interventions. However, its reliability has been improved in recent years. Its responsiveness to change is important, but more research is needed before it can be used for clinical practice. The NIHSS was developed by experts in the field of stroke and ischemic diseases. It is an important tool for assessing stroke severity and determining post-acute care.

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The NIHSS score has been found to be quite accurate in predicting patient outcomes, though it has shown limited success in cases of isolated cortex stroke. A score of 16 or higher is considered high risk for a patient's death. Similarly, a score of six or lower indicates a high probability of recovery. Furthermore, each one-point increase on the NIHSS decreases the likelihood of a positive outcome by 17 percent. The NIHSS score is therefore crucial for the course of action following a stroke.

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The NIHSS is composed of four components. The sensory component evaluates the patient's sensitivity and response to stimuli. The LOC and the best language elements assess the patient's ability to communicate. The extinction and inattention tests assess the level of attention. The scores are calculated by comparing the areas under each curve. In determining the p value of each item, a paired t test is used to compare the scores.

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The motor arm and leg elements assess a patient's ability to move the arms and legs. The motor arm test assesses whether the patient can hold both arms or legs up for at least 5 seconds. The facial muscle element assesses how well the patient can move facial muscles and how they react to noxious stimuli. This element is very important in evaluating a patient's cognitive function. The score should not be less than five points.

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The NIHSS is widely used in clinical practice. Its inter-rater reliability is high and has become the de facto standard for regulatory compliance. In addition, healthcare professionals who are certified in using the NIHSS must meet a minimum level of competency in the use of the tool. However, there are some limitations to the NIHSS. The NIHSS score is not designed to measure the severity of a stroke.

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