NIHSS (Simplified)

How to use it

1. 1

   Train on NIHSS. Score must be performed by trained provider. Online certification available (nihsscertification.nih.gov).

2. 2

   Best performance. Motor: hold position 10 sec (arm) / 5 sec (leg) before scoring drift.

3. 3

   Document serially. Change of ≥4 points = clinically significant shift.

When to use it

Thrombolysis eligibility

NIHSS 4–25: typical window for IV alteplase consideration.

Thrombectomy selection

LVO suspected with NIHSS ≥6 → CT angiography.

Prognosis

NIHSS at 24h and 7 days predicts 90-day functional outcome.