Scandinavian Stroke Scale

The Scandinavian Stroke Scale was designed for ease of use by non-neurologists¹. It is simpler than the NIHSS and has comparable performance in predicting death or dependence after stroke ². The degree of neurological impairment measured by the Scandinavian Stroke Scale has been shown to correlate with ASPECTS score severity in acute stroke ³.

Classification

• consciousness: 2 (reacts to verbal commands but not fully conscious) to 6 (fully conscious)
• eye movements: 0 (conjugate eye deviation) to 4 (no gaze palsy)
• arm motor power on affected side: 0 (paralysis) to 6 (raises arm with normal strength)
• hand motor power on affected side: 0 (paralysis) to 6 (normal strength)
• leg motor power on affected side: 0 (paralysis) to 6 (normal strength)
• orientation: 0 (completely disoriented) to 6 (correct for time, place and person)
• speech: 0 (only answers yes/no or less) to 10 (no aphasia)
• facial palsy: 0 (present) to 2 (none)
• gait: 0 (bedridden/wheelchair) to 12 (walks 5 m without aids)

Interpretation

Stroke severity has been graded using this scale as ⁴: 

• mild: 43-58
• moderate: 26-42
• severe: 0-25