The National Institutes of Health Stroke Scale (NIHSS) is an clinical assessment that is used to evaluate and document stroke severity. This assessment is first performed by a certified clinician in the emergency department once a patient is suspected of having a stroke. The test will be repeated throughout hospitalization to determine progression of stroke.


The NIHSS includes 11 items and is scored out of 42 points, with greater scores indicating greater disability. The NIHSS looks at many domains including alertness, visual function, muscle strength (in the face, arms, and legs), sensory function, coordination, and language comprehension and production.


NIHSS scores can be used to predict short and long-term functional recovery from stroke. Results from this assessment help clinicians create an optimal medical and therapy treatment plan. Because the NIHSS is complicated, the medical team may choose to explain results in simpler terms to a stroke patient or their loved ones. It is important to know that you can always ask a doctor, nurse, or therapist to explain things in greater detail or differently to ensure that you fully understand.

Learn More:

NIH Stroke Scale International
View the NIHSS Instrument
Learn what an NIHSS Score Means

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