Focused Neurological Examination

In order to determine the functional severity of a stroke and allow objective assessment of a patient’s progress, use of a standardised stroke scoring tool is essential.

The most widely adopted tool is the National Institutes of Health Stroke Scale (NIHSS) score, first described in 1989 [18] and modified subsequently.

Although the decision to thrombolyse is not made solely on the basis of this scoring system, it is used in thrombolysis protocols to provide an objective baseline assessment of the neurological deficit against which improvement, or deterioration, can be judged.

The NIHSS for rapid measurement of neurological impairment has an online training programme.

Free training for all healthcare professionals on using the NIHSS scoring system is available at nihss-english.trainingcampus

Learning Bite

The efficacy of thrombolysis in stroke is inversely proportional to the time since symptom onset. ‘Time = Brain’.