National Institute of Health Stroke Scale

see The Modified National Institutes of Health Stroke Scale (mNIHSS)

NIHSS score <10 at 24 hours after stroke onset is a strong predictor of favorable outcomes at 90 days in patients treated with mechanical thrombectomy ¹⁾.

Early identification of patients who are most likely to develop malignant middle cerebral artery infarction based on clinical, radiographic, anatomic, and laboratory values can aid the clinician in offering decompressive hemicraniectomy (DHC) early. Previously published predictors of a National Institute of Health Stroke Scale score of >20, thrombus at the carotid terminus location, presence of nausea and vomiting, elevations of the white blood cell count, early involvement of >50% of the MCA territory on CT, and additional involvement of the anterior cerebral artery territory and/or posterior cerebral artery territory may be clinical tools to identify high-risk patients ²⁾ ³⁾.

¹⁾

Katano T, Suzuki K, Takeuchi M, Morimoto M, Kanazawa R, Takayama Y, Aoki J, Nishiyama Y, Otsuka T, Matsumaru Y, Kimura K; SKIP study Investigators. National Institutes of Health Stroke Scale Score Less Than 10 at 24 hours After Stroke Onset Is a Strong Predictor of a Favorable Outcome After Mechanical Thrombectomy. Neurosurgery. 2022 Sep 19. doi: 10.1227/neu.0000000000002139. Epub ahead of print. PMID: 36136364.

²⁾

Krieger DW, Demchuk AM, Kasner SE, Jauss M, Hantson L. Early clinical and radiological predictors of fatal brain swelling in ischemic stroke. Stroke.1999;30:287–292

³⁾

Kasner SE, Demchuk AM, Berrouschot J, Schmutzhard E, Harms L, Verro P, Chalela JA, Abbur R, McGrade H, Christou I, Krieger DW. Predictors of fatal brain edema in massive hemispheric ischemic stroke. Stroke.2001;32:2117–2123