Stroke Assessment

Acute stroke evaluation using the NIHSS (National Institutes of Health Stroke Scale), with symptom onset timing, consciousness, motor/sensory examination, and risk factors.

Scoring

Instrument: NIHSS. Range 0–42.

• 0 — no stroke symptoms.
• 1–4 — minor.
• 5–15 — moderate.
• 16–20 — moderate to severe.
• 21–42 — severe.

What it covers

Demographics; symptom onset; level of consciousness; best gaze and visual; facial palsy and motor; limb ataxia and sensory; language and dysarthria; extinction and inattention; risk factors; and current medications.

Relationship to neurology-assessment

This assessment is scoped specifically to acute stroke presentation, with symptom-onset timing as a first-class, time-critical field; Neurology Assessment uses the same NIHSS instrument within a broader general neurological workup (also covering headache, seizure, and cognitive screening). Use this one specifically for acute, time-sensitive stroke workflow.

Common pitfalls

• Treating symptom-onset time as approximate when it's actually time-critical — treatment eligibility (e.g. thrombolysis windows) depends on precise, "last known well" timing, not an approximate estimate; establishing this accurately is a priority, not a formality.
• Scoring NIHSS inconsistently across serial assessments — NIHSS needs a standardized, trained technique to be comparable across repeat assessments used to track improvement or deterioration.
• Delaying NIHSS scoring for a "complete" history — in acute stroke, rapid NIHSS scoring and time-critical actions (imaging, treatment eligibility) take priority over a fully comprehensive history, which can be completed once time-critical steps are underway.

Learn more

• FormExamples: stroke-assessment for the full implementation, clinical references, and worked examples.
• Neurology Assessment for the general neurological evaluation using the same instrument.