CDE Detailed Report

From NIHSS instructions: The patient is asked to open and close the eyes and then to grip and release the non-paretic hand. Substitute another one step command if the hands cannot be used. Credit is given if an unequivocal attempt is made but not completed due to weakness. 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). Patients with trauma, amputation, or other physical impediments should be given suitable one-step commands. Only the first attempt is scored. This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS instructions: 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 1. If a patient has an isolated peripheral nerve paresis (CN III, IV or VI) score a 1. Gaze is testable in allaphasic patients. Patients with ocular trauma, bandages, pre-existing blindness or other disorder of visual acuity or fields should be tested with reflexive movements and a choice made by the investigator. Establishing eye contact and then moving about the patient from side to side will occasionally clarify the presence of a partial gaze palsy. This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS instructions: Visual fields (upper and lower quadrants) are tested by confrontation, using finger counting or visual threat as appropriate. Patient must be encouraged, but if they look at the side of the moving fingers appropriately, this can be scored as normal. If there is unilateral blindness or enucleation, visual fields in the remaining eye are scored. Score 1 only if a clear-cut asymmetry, including quadrantanopia is found. If patient is blind from any cause score 3. This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS instructions: Ask, or use pantomime to encourage the patient to show teeth or raise eyebrows and close eyes. Score symmetry of grimace in response to noxious stimuli in the poorly responsive or non-comprehending patient. If facial trauma/bandages, orotracheal tube, tape or other physical barrier obscures the face, these should be removed to the extent possible. This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS instructions: The limb is placed in the appropriate position - extend the arms (palms down) 90 degrees (if sitting) or 45 degrees (if supine) and the leg 30 degrees (always tested supine). Drift is scored if the arm falls before 10 seconds or the leg before 5 seconds. The aphasic patient is encouraged using urgency in the voice and pantomime but not noxious stimulation. Each limb is tested in turn, beginning with the non-paretic arm. Only in the case of amputation or joint fusion at the shoulder or hip may the score be "UN" and the examiner must clearly write the explanation for scoring as a "UN". This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS instructions: The limb is placed in the appropriate position - extend the arms (palms down) 90 degrees (if sitting) or 45 degrees (if supine) and the leg 30 degrees (always tested supine). Drift is scored if the arm falls before 10 seconds or the leg before 5 seconds. The aphasic patient is encouraged using urgency in the voice and pantomime but not noxious stimulation. Each limb is tested in turn, beginning with the non-paretic arm. Only in the case of amputation or joint fusion at the shoulder or hip may the score be "UN" and the examiner must clearly write the explanation for scoring as a "UN". This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS: This item is aimed at finding evidence of a unilateral cerebellar lesion. Test with eyes open. In case of visual defect, insure testing is done in intact visual field. The finger-nose-finger and heel-shin tests are performed on both sides, and ataxia is scored only if present out of proportion to weakness. Ataxia is absent in the patient who cannot understand or is paralyzed. Only in the case of amputation or joint fusion may the item be scored "UN", and the examiner must clearly write the explanation for not scoring. In case of blindness test by touching nose from extended arm position. This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS: Sensation or grimace to pin prick when tested, or withdrawal from noxious stimulus in the obtunded or aphasic patient. Only sensory loss attributed to stroke is scored as abnormal and the examiner should test as many body areas [arms (not hands), legs, trunk, face] as needed to accurately check for hemisensory loss. A score of 2, "severe or total," should only be given when a severe or total loss of sensation can be clearly demonstrated. Stuporous and aphasic patients will therefore probably score 1 or 0. The patient with brain stem stroke who has bilateral loss of sensation is scored 2. If the patient does not respond and is quadriplegic score 2. Patients in coma (item 1a=3) are arbitrarily given a 2 on this item. This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type

Only choice for Arch is N/A - Not Present

Supplemental - Highly Recommended based on study type, disease stage and disease type

From NIHSS instructions: The investigator must choose a response, even if a full evaluation is prevented by such obstacles as an endotracheal tube, language barrier, orotracheal trauma/bandages. A 3 is scored only if the patient makes no movement (other than reflexive posturing) in response to noxious stimulation. This element should be collected with the other elements of the NIH Stroke Scale (NIHSS).

Supplemental - Highly Recommended based on study type, disease stage and disease type