What are the limitations of the National Institutes of Health Stroke Scale (NIHSS) in assessing clinical deficits in transient ischemic attack (TIA)?

Updated: Dec 03, 2018
  • Author: Ashish Nanda, MD; Chief Editor: Andrew K Chang, MD, MS  more...
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Answer

The NIHSS is a 42-point scale, with minor strokes usually being considered to result in a score lower than 5. An NIHSS score higher than 10 correlates with an 80% likelihood of visual flow deficits on angiography. Yet, discretion must be used in assessing the magnitude of the clinical deficit; for instance, if a patient’s only deficit is being mute, the NIHSS score will be 3. Additionally, the scale does not measure some deficits associated with posterior circulation strokes (eg, vertigo and ataxia).


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