The NIHSS-Plus: Improving Cognitive Assessment with the NIHSS

The NIHSS-Plus: Improving Cognitive Assessment with the NIHSS

BACKGROUND The National Institutes of Health Stroke Scale (NIHSS) has been criticized for limited representation of cognitive dysfunction and bias towards dominant hemisphere functions. Patients may therefore receive a low NIHSS score despite a fairly large stroke. A broader scale including simple cognitive tests would improve the clinical and research utility of the NIHSS. METHODS We studied...

Is the NIHSS certification process too lenient?

BACKGROUND AND PURPOSE The National Institutes of Health Stroke Scale (NIHSS) is a widely used measure of neurological function in clinical trials and patient assessment; inter-rater scoring variability could impact communications and trial power. The manner in which the rater certification test is scored yields multiple correct answers that have changed over time. We examined the range of poss...

National Institutes of Health Stroke Scale (NIHSS).

NIHSS/EIC Mismatch Explains the >1⁄3 MCA Conundrum

>1⁄3 MCA Conundrum To the Editor: The controversy about the significance of early ischemic changes (EIC) on CT after acute stroke by von Kummer, Lyden, and Davis and Donnan1–3 nicely summarizes the issues except for what, in my mind, is the most likely explanation for the discrepancy between the NINDS and ECASS conclusions on this subject. I would also like to propose an alternative way of look...

NIHSS/EIC Mismatch Explains the >1⁄3 MCA Conundrum

>1⁄3 MCA Conundrum To the Editor: The controversy about the significance of early ischemic changes (EIC) on CT after acute stroke by von Kummer, Lyden, and Davis and Donnan1–3 nicely summarizes the issues except for what, in my mind, is the most likely explanation for the discrepancy between the NINDS and ECASS conclusions on this subject. I would also like to propose an alternative way of look...