⚕️ For clinical reference only. Not a substitute for professional judgment.

NIH Stroke Scale NIHSS

Quantifies stroke severity across 11 domains. Guides thrombolysis eligibility, thrombectomy, and prognosis.

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Score each domain

Complete all 11 domains to calculate total NIHSS.

1a — Level of Consciousness

1b — LOC Questions (month + age)

1c — LOC Commands (close eyes + grip)

2 — Best Gaze

3 — Visual Fields

4 — Facial Palsy

5a — Left Arm Motor

5b — Right Arm Motor

6a — Left Leg Motor

6b — Right Leg Motor

7 — Limb Ataxia

8 — Sensory

9 — Best Language

10 — Dysarthria

11 — Extinction / Inattention

Severity Bands

0: No stroke symptoms 1–4: Minor stroke 5–15: Moderate stroke 16–20: Moderate–severe stroke 21–42: Severe stroke Thrombolysis: consider if NIHSS 4–25, within 4.5h Thrombectomy: consider if NIHSS ≥6, proximal LVO confirmed on CTA

References

Brott T et al. Measurements of acute cerebral infarction. Stroke. 1989;20(7):864–70.
NICE NG128. Stroke and TIA in over 16s. 2019.