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About this tool
Fifteen-item neurological examination quantifying stroke severity (0–42).
Intended use
Patients with suspected acute stroke, by trained examiners.
Outcome
Stroke severity
Time horizon
Point in time
Derivation population
Developed in acute stroke trials.
Limitations
- Weighted toward anterior-circulation deficits; posterior strokes may score low.
- Requires training for reliable scoring.
Clinical problems
Evidence
Evidence level
Strong evidence
Derived and externally validated in multiple cohorts (including prospective studies) and incorporated into major clinical guidelines. Methodology
Guideline status
Recommended for initial stroke severity assessment in AHA/ASA acute ischaemic stroke guidelines.
References
- Original publicationBrott T, Adams HP Jr, Olinger CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke 1989;20:864-870. Find on PubMed (opens in a new tab)
Version history
| Version | Formula | Effective | Reviewer | Changes |
|---|---|---|---|---|
| v1.0.0 | NINDS NIHSS | 2026-10-03 | — | Initial implementation with reference test vectors. |
Related tools
Clinical decision support only. Interpret results in the context of the individual patient and current guidance; HumanPulse does not replace professional medical judgment.