Stroke Assessment (NIH Stroke Scale)

The Stroke Assessment Form implements the National Institutes of Health Stroke Scale (NIHSS), the most widely used standardized instrument for quantifying neurological deficit severity in acute stroke patients. It systematically evaluates 11 domains , level of consciousness (including orientation and command response), best gaze, visual fields, facial palsy, motor function in each extremity, limb ataxia, sensory function, language (aphasia), dysarthria, and extinction/inattention (neglect). Each item is scored on a defined ordinal scale, producing a total NIHSS score that correlates with stroke severity, guides acute treatment decisions such as thrombolytic eligibility, and predicts long-term outcome.

Beyond the core NIHSS items, this template captures essential acute stroke workflow data including symptom onset time (last known well), current blood pressure and glucose readings, stroke type classification (ischemic vs. hemorrhagic), and imaging findings. It documents the time-critical decision points for thrombolytic therapy (tPA) or endovascular intervention eligibility, including contraindication screening. A section for recording serial NIHSS scores at defined intervals (baseline, 2 hours, 24 hours, discharge) supports monitoring of neurological trajectory, enabling early detection of clinical improvement or deterioration that may require intervention.

Designed for emergency departments, stroke centers (primary and comprehensive), neurology inpatient services, and telestroke programs, this form supports compliance with Get With The Guidelines-Stroke (GWTG-Stroke) quality measures and Joint Commission Primary Stroke Center certification requirements. It provides the rapid, reproducible neurological assessment framework that stroke teams need to make time-sensitive treatment decisions while maintaining the documentation quality required for quality reporting, outcome tracking, and clinical research.