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What is the NIHSS Stroke Scale? - Oren Zarif - Nih Stroke Scale


NIHSS is a short assessment that consists of three to five grades. The scale scores from 0 to 4, with zero meaning normal function. Scores higher than four indicate a certain degree of disability. It takes less than 10 minutes to complete and requires minimal input. You can use the website to view pictures, a naming sheet, and a list of sentences. You can complete the NIHSS in as few as four minutes.

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The NIHSS is an excellent tool for evaluating neurologic impairment. A skilled healthcare provider can determine a patient's level of impairment in a matter of minutes. Moreover, it provides a reliable baseline for stroke treatment assessment and prognosis. Several studies have confirmed the usefulness of this tool and have even published research based on it. But before you use this tool to rate patients, it's best to consult a stroke treatment protocol.

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The NIHSS is a standardized scoring tool that neurologists use to determine a patient's degree of impairment after a stroke. The NIHSS scores vary by brain region, and some strokes are more severe than others. NIHSS can be used to determine if an individual's symptoms improve or worsen over time. The NIHSS is also helpful for guiding treatment decisions and providing a standard scale for healthcare providers.

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The NIHSS is a useful tool to determine whether a patient is at high risk for severe disability or is at low risk for a long-term recovery. The results of the study suggest that the NIHSS is an effective tool for predicting the level of care after acute stroke. A score between six and thirteen is indicative of a favorable outcome. A score of nine or higher is indicative of poor recovery.

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MRI lesion volumes and baseline NIHSS score were related to outcome. In 49 stroke patients, baseline NIHSS scores were significantly correlated with lesion volumes and perfusion-weighted imaging abnormality volume. Further, the NIHSS scores were related to time to peak delays and the location of arterial occlusion. This means that stroke patients may not be suffering from a severe lesion but still have low NIHSS scores.

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Although NIHSS scores are associated with infarction size, the results showed that most patients improved clinically after 1 week. However, four out of 15 items only improved minimally: facial palsy, plantar reflex, dysarthria, and language. This suggests that limb ataxia and best gaze may have been overstated. Among the other 10 items, changes in only 25% were noted after 7 days.

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Agreement between prospective and retrospective NIHSS scores was excellent for the limb ataxia and language items. The overall agreement was good for all items, but varying levels of agreement were noted for some. For example, limb ataxia and facial expression were rated as low agreement in the study of Oh et al. In this study, NIHSS was equally reliable among 19 raters who used the Korean version of the scale.

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Among 389 patients, Albers, Bates, Clark, Bell, and Hamilton(2000) found that lower NIHSS scores were associated with a better outcome. A 5-point increase in NIHSS decreased the chance of recovery by 22%, while a score over 10 decreased the chance of recovery by 75%. This study shows that the NIHSS is a valid measure of stroke severity, and should be used as a guide when deciding on the type of treatment for patients with acute stroke.

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Although aNIHSS has low overall reliability, it is better than no measure when it comes to measuring functional independence. The aNIHSS has a positive predictive value of 90.6% compared to a negative predictive value of 78.6%. Its p value is 0.05. When used in conjunction with NINDS-TPA, the NIHSS has good predictive value for functional outcomes.

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The NIHSS has several limitations. Its high sensitivity does not mean that a large percentage of stroke patients will recover. A patient's NIHSS score may be underestimated if the patient has severe brain damage. NIHSS scores are also correlated with post-admission Barthel Index scores. These data should be adjusted appropriately for baseline severity. The NIHSS score has become an important tool in demonstrating compliance with the requirements of the healthcare regulatory agencies.

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