NIH Stroke Scale

Medical doctor wearing blue scrubs uniform and stethoscope around neck using a tablet.

Assess risk by using the NIH Stroke Scale. Developed through research supported by NINDS, the widely used NIH Stroke Scale helps health care providers assess the severity of a stroke. Health care providers use it to measure neurological function and deficits by asking the person to answer questions and perform several physical and mental tests. This checklist of questions and tasks scores a person's level of alertness and ability to communicate and perform simple movements.

Download the NIH Stroke Scale
The NIH Stroke Scale was created for healthcare providers to diagnose and treat stroke patients.

How to use the NIH Stroke Scale:

Using a numerical scale to determine stroke severity, health care providers record the person’s performance in 11 categories, such as sensory and motor ability. The following example shows the specific instructions used to correctly determine performance, and the scale scoring, for category 1a.

Level of Consciousness:

The health care provider must choose a response if a full evaluation is prevented by such obstacles as an endotracheal tube, language barrier, orotracheal trauma/bandages. A 3 is scored only if the person makes no movement (other than reflexive posturing) in response to noxious stimulation.

  • 0 = Alert; keenly responsive. 
  • 1 = Not alert; but arousable by minor stimulation to obey, answer, or respond. 
  • 2 = Not alert; requires repeated stimulation to attend or is obtunded and requires strong or painful stimulation to make movements (not stereotyped). 
  • 3 = Responds only with reflex motor or autonomic effects or is totally unresponsive, flaccid, and areflexic.

Stroke Scale Training Tools

BlueCloud® NIH Stroke Scale Certification

Apex Innovations Interactive Training Tool

American Heart Association Stroke Scale Course