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The NIH Stroke Scale is a clinical rating scale used to assess the likelihood of an individual having a stroke based on their clinical examination. It evaluates motor function, cognition, sensory function, level of consciousness, vision, and speaking ability, and patients receive a score ranging from zero to 30. A low score suggests a good prognosis, while a high score suggests a poor prognosis. The scale is used by various healthcare providers and is often evaluated immediately upon presentation to the emergency department and periodically throughout recovery.
In the United States, the National Institutes of Health Stroke Scale (NIHSS) is a clinical rating scale used to assess the likelihood of an individual having a stroke, based on the findings of the patient’s clinical examination. Evaluate a person’s ability to move, speak, see, and understand by asking questions and performing diagnostic maneuvers such as strength testing. The lower the score, the less likely a person is to have a stroke. Often a patient’s score is monitored periodically throughout their recovery period.
The items on the NIH Stroke Scale assess a patient’s motor function, cognition, sensory function, level of consciousness, vision, and speaking ability. In order to assess their overall ability to think, patients are asked simple questions such as their age or what month of the year it is. The health care provider asks the patient to wiggle the extremities and face in an attempt to assess motor skills. To assess speech, patients are asked to read a few specified sentences aloud.
Patients evaluated using the NIH stroke scale receive a numerical score ranging from zero to 30. A normal person with no neurological or cognitive defects would receive a score of zero. With a severe stroke, a person may receive a score of 25 or higher. Some researchers have shown that a patient’s initial stroke scale score correlates well with their overall outcome. In other words, a low score suggests a good prognosis, while a high score suggests a poor prognosis.
Many different healthcare providers can use the NIH Stroke Scale to evaluate a patient. Although physicians – emergency room physicians or neurologists – often administer the test, other health professionals may also be trained in how to use this clinical tool. A patient can also be evaluated by a healthcare professional using telehealth, which means that a centrally located physician can evaluate a patient located far away with the use of real-time video.
Often a patient’s NIH stroke score is evaluated immediately upon presentation to the emergency department. If patients receive treatment for an acute stroke, such as an intravenous thrombolytic agent that helps break up blood clots that could cause a stroke, the patient’s score is recalculated two hours after the treatment is administered. Patients are often then evaluated 24 hours, seven days, and three months after symptoms begin. The patient’s position on the scale therefore serves as an indicator of how well he has recovered from an acute stroke.
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