NIH Stroke Scale Exam with Answers

NIH Stroke Scale Page 1 of 9 NIH Stroke Scale Exam with Answers Question 1 How to assess Level of Consciousness?Correct Answer 1a. Deteremine if patient is alert, oriented x4 1b. The patient is asked the month and his/her age.The answer must be correct - there is no partial credit for being close. Aphasic and stuporous patients who do not comprehend the questions will score 2. It is important that only the initial answer be graded and that the examiner not "help" the patient with verbal or non-verbal cue.1c. The patient is asked to open and close the eyes and then to grip and release the non-paretic hand. If the patient does not respond to command, the task should be demonstrated to him or her (pantomime), and the result scored (i.e., follows none, one or two commands) 1 / 2

NIH Stroke Scale Page 2 of 9 Question 2 What are the results?Correct Answer

• = Alert; keenly responsive.
• = Not alert; but arousable by minor stimulation to obey,

answer, or respond.

• = Not alert; requires repeated stimulation to attend, or is obtunded and requires

strong or painful stimulation to make movements (not stereotyped).

• = Responds only with reflex motor or autonomic effects or totally unresponsive,

flaccid, and areflexic.

• = Answers both questions correctly.
• = Answers one question correctly.
• = Answers neither question correctly
• = Performs both tasks correctly.
• = Performs one task correctly.
• = Performs neither task correctly.

Question 3 How to assess best gaze?Correct Answer Only horizontal eye movements will be tested.Voluntary or reflexive (oculocephalic) eye movements will be scored, but caloric testing is not done. If the patient has a conjugate deviation of the eyes that can be overcome by voluntary or reflexive activity, the score will be 1If a patient has an isolated peripheral nerve paresis (CN III, IV or VI), score a 1 Question 4 What are the results?Correct Answer

• = Normal.
• = Partial gaze palsy; gaze is abnormal in one or both eyes,

but forced deviation or total gaze paresis is not present.

• = Forced deviation, or total gaze
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