NIH Stroke Scale Calculator

Created by Joanna Michałowska, PhD candidate
Reviewed by Dominik Czernia, PhD candidate and Jack Bowater
Last updated: Feb 15, 2022

The NIH stroke scale calculator (NIHSS calculator) helps to objectively assess the impairment caused by a stroke. It consists of 11 sections, where each item can be scored with three to five grades. The NIH stroke scale design is simple, and this tool is considered valid and reliable. It can be routinely administered at the bedside by physicians, nurses, and/or therapists.

You might also be interested in our other health tools. Check out the SOFA score, HEART score, or Branden score calculators.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace professional medical advice.

What is a stroke?

Stroke is the fifth leading cause of death in the US and is a significant cause of severe disability for adults. This condition is associated with poor blood flow in the brain, which causes cell death. A stroke can cause lasting brain damage, long-term disability, or death.

There are two types of stroke:

  • An ischemic stroke (more prevalent, 87% of cases) - occurs when blood vessels in the brain are blocked (e.g., by blood clots, plaque).
  • A hemorrhagic stroke - occurs when a blood vessel bursts in the brain and the blood build-up damages the surrounding brain tissue.

Risk factors of stroke include:

Signs of stroke:

  • sudden numbness or weakness in the face/arm/leg (especially on one side of the body);
  • sudden confusion, trouble speaking, or difficulty understanding speech;
  • loss of balance/lack of coordination;
  • severe headache with no known cause; and
  • visual field defects.

If someone has those symptoms, act F.A.S.T.

If you think someone may be having a stroke, act F.A.S.T (F- Face; A - Arms; S - Speech; T - Time)
Source: Centers for Disease Control and Prevention

NIH stroke scale score (NIHSS score)

The National Institutes of Health Stroke Scale (NIHSS) is an assessment tool that objectively quantifies the impairment caused by a stroke by quantitatively measuring a stroke-related neurologic deficit. The NIHSS was initially designed as a research tool to measure patients' data in clinical trials, however, now we widely use the scale in the clinical setting.

Doctors use of NIH stroke scale score for the:

  • evaluation of acuity of stroke patients;
  • determination of appropriate treatment;
  • prediction of patient outcome;
  • evaluation and documentation of neurological status;
  • prediction of lesion size;
  • measurement of stroke severity;
  • prediction of both short and long term outcomes;
  • data collection tool for planning patient care; and
  • provision of a common language for information exchanges among healthcare providers.

NIH stroke scale calculator

The NIH stroke scale calculator consists of 15 items, which evaluate the effect of acute cerebral infarction on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory impairment.

Each item contains three to five grades and can score from 0 to 4 points, where a score of 0 typically indicates normal function, while a higher score indicates some level of impairment. The assessment usually requires less than 10 minutes to complete.

How to use the NIH stroke scale calculator? It is straightforward as you only need to go through all the fields from the top to the bottom. As a result you'll obtain the NIHSS score together with an interpretation in the table at the very end.

Check the English version of NIH stroke scale (pdf format) for more details about NIHSS score. The website includes pictures, naming sheet and list of sentences that we use during the assessment.

NIH stroke scale score

To obtain the NIHSS score, we sum all individual scores. The maximum possible score is 42, and the minimum score equals 0.

The table below presents the interpretation of the results:

Score
Stroke severity
0
No stroke symptoms
1-4
Minor stroke
5-15
Moderate stroke
16-20
Moderate to severe stroke
21-42
Severe stroke
Joanna Michałowska, PhD candidate
Level of Consciousness (LOC) questions:
1A. Responsiveness
Select...
1B. Ask month and age
Select...
1C. Command ℹ️
Select...
Face and vision:
2. Best gaze ℹ️
Select...
3. Visual fields ℹ️
Select...
4. Facial palsy ℹ️
Select...
Limbs:
5A. Motor arm - left ℹ️
Select...
5B. Motor arm - right ℹ️
Select...
6A. Motor leg - left ℹ️
Select...
6B. Motor Leg - right ℹ️
Select...
7. Limb ataxia ℹ️
Select...
Sensation and speech:
8. Sensation to pinprick
Select...
9. Language/aphasia ℹ️
Select...
10. Dysarthria
Select...
11. Extinction/inattention ℹ️
Select...
Results
NIHSS score
Interpretation:
ScoreStroke severity
0No stroke symptoms
1-4Minor stroke
5-15Moderate stroke
16-20Moderate to severe stroke
21-42Severe stroke
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