- It was originally developed in 19891 and is now the most widely used outcome measure in the recombinant tissue plasminogen activator stroke trials.
NIHSS includes the following domains:
- Level of consciousness
- Eye movements
- Integrity of visual fields
- Facial movements
- Arm and leg muscle strength
- Language, speech and neglect
Each impairment is scored on an ordinal scale ranging from 0 to 2, 0 to 3, or 0 to 4. Item scores are summed to a total score ranging from 0 to 42 (the higher the score, the more severe the stroke).