The Utility of Quantifiable Neurologic Assessments After Stroke: In response to Marsh et al, 'The NIH Stroke Scale Has Limited Utility in Accurate Daily Monitoring of Neurologic Status'

摘要

In the most recent edition of The Neurohospitalist, Marsh and colleagues reported a significant limitation of serial National Institutes of Health Stroke Scale (NIHSS) assessments in patients with acute ischemic stroke.1 The investigators rightfully concluded that an improvement in 4 points on the NIHSS was less sensitive for detecting neurologic recovery when compared to a comprehensive neurologic examination. Recognition of this weakness is pertinent to all clinicians who rely on the NIHSS to identify neurologic recovery (or worsening), especially when using a prethresholded NIHSS improvement in the definition of recovery.