NIH Stroke Scale/Score (NIHSS) Calculator

[fstyle]

NIH Stroke Scale/Score (NIHSS) Calculator
1A: Level of consciousness
1B: Ask month and age
1C: ‘Blink eyes’ & ‘squeeze hands’
2: Horizontal extraocular movements (Only assess horizontal gaze)
3: Visual fields
4: Facial palsy (Use grimace if obtunded)
5A: Left arm motor drift (Count out loud and use your fingers to show the patient your count)
5B: Right arm motor drift (Count out loud and use your fingers to show the patient your count)
6A: Left leg motor drift (Count out loud and use your fingers to show the patient your count)
6B: Right leg motor drift (Count out loud and use your fingers to show the patient your count)
7: Limb Ataxia FNF/heel-shin
8: Sensation
9: Language/aphasia {Describe the scene; name the items; read the sentences (see Evidence)}
10: Dysarthria {Read the words (see Evidence)}
11: Extinction/inattention
[/fstyle]

Put on your lab coats and safety goggles, because we’re about to dive deep into the world of NIH Stroke Scale/Score (NIHSS)! This isn’t your grandma’s knitting pattern, folks, this is cutting-edge medical science.

NIHSS Calculation Formula

Ready for some number crunching? Here’s the calculation formula that makes the NIHSS tick:

score = sum(each_item_score)

In the NIHSS, each item is scored with 3 to 5 grades, with 0 being as normal as your love for pizza. The total NIHSS score is calculated as the sum of each item score, simple as that.

NIHSS Categories and Interpretation

Score Category Stroke Severity
0 No Stroke None
1-4 Minor Stroke Low
5-15 Moderate Medium
16-20 Moderate Severe High
21+ Severe Stroke Very High

NIHSS Calculation Examples

Let’s put some faces to these numbers. Here’s how a few folks might score:

Name Symptoms NIHSS Score Calculation Method
Bob No visible symptoms, healthy individual 0 0+0+0+0+0+0+0+0+0
Alice Partial facial droop, some difficulty moving left arm 3 1+1+1+0+0+0+0+0+0
Charlie Complete left-side paralysis, unable to speak or comprehend 21 4+4+4+4+2+2+1+0+0

Evolution of NIHSS

Just like a fine wine, the NIHSS has improved over time. Here’s a quick rundown of its evolution:

Year Event
1989 NIHSS was first developed
1996 NIHSS became the standard for clinical stroke assessment
2001 Widespread training in NIHSS increased its usage
2010 Online version of NIHSS was made available

Limitations of NIHSS

Every system has its limitations, and the NIHSS is no exception:

  1. Lack of Sensitivity: The NIHSS might not detect small but clinically significant changes in a patient’s condition.
  2. Bias Towards Motor Function: The NIHSS places a greater emphasis on motor function, which might underestimate the severity of non-motor symptoms.
  3. Inaccuracy in Predicting Long-term Outcome: The NIHSS might not accurately predict the long-term outcome of a stroke.

Alternative Methods

For those who like options, here are some alternative methods:

Method Pros Cons
Barthel Index Measures functional independence Might not detect subtle improvements
mRS Widely used, simple Subjective, might lack sensitivity

FAQs

  1. What is the NIHSS? The NIHSS is a scale used to assess the severity of a stroke.
  2. How is the NIHSS score calculated? The NIHSS score is calculated by summing the scores of each item. Each item is scored with 3 to 5 grades, with 0 being normal.
  3. How is the NIHSS score interpreted? The NIHSS score is interpreted based on the severity of the stroke. The higher the score, the more severe the stroke.
  4. What is a good NIHSS score? A score of 0 is considered normal, indicating no stroke.
  5. Can the NIHSS score predict the outcome of a stroke? While the NIHSS score can provide an indication of the severity of a stroke, it may not accurately predict the long-term outcome of a stroke.
  6. What are the limitations of the NIHSS? The NIHSS may not detect small but clinically significant changes, may be biased towards motor function, and may not accurately predict long-term outcomes.
  7. Are there alternatives to the NIHSS? Yes, some alternatives to the NIHSS include the Barthel Index and the mRS.
  8. What is the Barthel Index? The Barthel Index is an alternative method that measures functional independence but might not detect subtle improvements.
  9. What is the mRS? The mRS is a widely used, simple alternative to the NIHSS. However, it might lack sensitivity and can be subjective.
  10. Where can I learn more about the NIHSS? You can learn more about the NIHSS from the National Institute of Neurological Disorders and Stroke (NINDS) and the American Stroke Association.

References for Further Research

  1. National Institute of Neurological Disorders and Stroke (NINDS)
  2. American Stroke Association

These resources provide detailed information on the NIHSS and can be useful for those looking to dive deeper into the topic.