Q: One of the limitations of the National Institutes of Health Stroke Scale (NIHSS) score is that it does not cover all stroke-related impairments?
A) True
B) False
Answer: A
NIHSS is a validated score used as a standard of care during the initial presentation of acute stroke. It is also a good tool to predict the long-term outcome of stroke. It has become more widely used since tele-stroke programs are in rise. It can also be calculated retrospectively from medical charts for clinical studies. Said that it has its own limitations and pitfalls like it does not cover all impairments from a stroke. It doesn't provide much info from a defect in posterior (vertebrobasilar) circulation. A patient may have a large stroke in a posterior circulation but may still have a normal NIHSS score.
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References:
1. Kasner SE. Clinical interpretation and use of stroke scales. Lancet Neurol 2006; 5:603.
2. Martin-Schild S, Albright KC, Tanksley J, et al. Zero on the NIHSS does not equal the absence of stroke. Ann Emerg Med 2011; 57:42.
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