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NIH STROKE SCALE GROUP D PATIENT
1-6 Complete Actual Exam 2026/2027
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PATIENT 1
NIHSS Item Scores: 1a. LOC: 0 - Alert and responsive 1b. LOC Questions: 0 - Answers both
correctly 1c. LOC Commands: 0 - Performs both tasks correctly 2. Best Gaze: 0 - Normal 3.
Visual: 0 - No visual loss 4. Facial Palsy: 1 - Minor paralysis (nasolabial fold flattening) 5a.
Motor Arm - Left: 0 - No drift 5b. Motor Arm - Right: 0 - No drift 6a. Motor Leg - Left: 0 - No
drift 6b. Motor Leg - Right: 0 - No drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 0 - Normal 9.
Best Language: 0 - No aphasia 10. Dysarthria: 0 - Normal 11. Extinction/Inattention: 0 - No
abnormality
Total Score: 1/42
Scoring Notes: Patient 1 represents a minor stroke with only subtle facial asymmetry. The facial
palsy score of 1 indicates minor paralysis with preserved movement in the upper face and some
flattening of the nasolabial fold. This is consistent with a small lacunar or minor cortical stroke
affecting facial motor pathways without significant motor, sensory, or cognitive deficits.
PATIENT 2
NIHSS Item Scores: 1a. LOC: 0 - Alert 1b. LOC Questions: 0 - Answers both correctly 1c. LOC
Commands: 0 - Performs both tasks correctly 2. Best Gaze: 1 - Partial gaze palsy 3. Visual: 0 -
No visual loss 4. Facial Palsy: 2 - Partial paralysis (lower face) 5a. Motor Arm - Left: 3 - No
effort against gravity 5b. Motor Arm - Right: 0 - No drift 6a. Motor Leg - Left: 3 - No effort
against gravity 6b. Motor Leg - Right: 0 - No drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 1 -
Mild-to-moderate sensory loss 9. Best Language: 0 - No aphasia 10. Dysarthria: 1 - Mild-to-
moderate dysarthria 11. Extinction/Inattention: 0 - No abnormality
Total Score: 11/42
Scoring Notes: Patient 2 demonstrates a classic right hemisphere stroke presentation with left-
sided deficits. The gaze palsy (1) reflects impaired eye movement toward the left. Left arm and
, 2
leg both score 3, indicating hemiplegia without any effort against gravity. Facial palsy (2) is
partial, affecting primarily the lower left face. Dysarthria (1) and mild sensory loss (1) are
consistent with right hemisphere involvement. The absence of aphasia supports right hemisphere
localization.
PATIENT 3
NIHSS Item Scores: 1a. LOC: 1 - Not alert but arousable (drowsy, requires verbal stimulation)
1b. LOC Questions: 1 - Answers one correctly (month, not age) 1c. LOC Commands: 2 -
Performs neither correctly 2. Best Gaze: 0 - Normal 3. Visual: 0 - No visual loss 4. Facial Palsy:
0 - Normal 5a. Motor Arm - Left: 0 - No drift 5b. Motor Arm - Right: 0 - No drift 6a. Motor Leg
- Left: 0 - No drift 6b. Motor Leg - Right: 0 - No drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 0 -
Normal 9. Best Language: 2 - Severe aphasia 10. Dysarthria: 2 - Severe dysarthria (untestable
due to aphasia) 11. Extinction/Inattention: 0 - No abnormality
Total Score: 6/42
Scoring Notes: Patient 3 presents with altered consciousness and severe language dysfunction
without significant motor deficits. The drowsiness (1a=1) and inability to follow commands
(1c=2) reflect reduced alertness. The severe aphasia (9=2) is the dominant finding—patient
cannot communicate effectively through speech or comprehension. Dysarthria is scored 2 as
"untestable" due to the overriding aphasia per NIHSS guidelines. This pattern suggests a
dominant hemisphere (left) stroke affecting language centers, possibly with some mass effect
causing drowsiness.
PATIENT 4
NIHSS Item Scores: 1a. LOC: 0 - Alert 1b. LOC Questions: 0 - Answers both correctly 1c. LOC
Commands: 0 - Performs both tasks correctly 2. Best Gaze: 0 - Normal 3. Visual: 2 - Complete
hemianopia (left visual field) 4. Facial Palsy: 0 - Normal 5a. Motor Arm - Left: 0 - No drift 5b.
Motor Arm - Right: 0 - No drift 6a. Motor Leg - Left: 0 - No drift 6b. Motor Leg - Right: 0 - No
drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 0 - Normal 9. Best Language: 0 - No aphasia 10.
Dysarthria: 0 - Normal 11. Extinction/Inattention: 2 - Profound hemi-inattention (left-sided)
Total Score: 4/42
Scoring Notes: Patient 4 demonstrates isolated right hemisphere dysfunction with complete left
hemianopia (2) and profound left-sided neglect/inattention (2). The visual field loss is complete,
not partial. The extinction/inattention score of 2 reflects severe neglect where the patient fails to
recognize or attend to left-sided stimuli despite intact primary sensory pathways. This pattern is
NIH STROKE SCALE GROUP D PATIENT
1-6 Complete Actual Exam 2026/2027
Questions and Verified Answers 100%
Verified Pass Guaranteed - A+ Graded
PATIENT 1
NIHSS Item Scores: 1a. LOC: 0 - Alert and responsive 1b. LOC Questions: 0 - Answers both
correctly 1c. LOC Commands: 0 - Performs both tasks correctly 2. Best Gaze: 0 - Normal 3.
Visual: 0 - No visual loss 4. Facial Palsy: 1 - Minor paralysis (nasolabial fold flattening) 5a.
Motor Arm - Left: 0 - No drift 5b. Motor Arm - Right: 0 - No drift 6a. Motor Leg - Left: 0 - No
drift 6b. Motor Leg - Right: 0 - No drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 0 - Normal 9.
Best Language: 0 - No aphasia 10. Dysarthria: 0 - Normal 11. Extinction/Inattention: 0 - No
abnormality
Total Score: 1/42
Scoring Notes: Patient 1 represents a minor stroke with only subtle facial asymmetry. The facial
palsy score of 1 indicates minor paralysis with preserved movement in the upper face and some
flattening of the nasolabial fold. This is consistent with a small lacunar or minor cortical stroke
affecting facial motor pathways without significant motor, sensory, or cognitive deficits.
PATIENT 2
NIHSS Item Scores: 1a. LOC: 0 - Alert 1b. LOC Questions: 0 - Answers both correctly 1c. LOC
Commands: 0 - Performs both tasks correctly 2. Best Gaze: 1 - Partial gaze palsy 3. Visual: 0 -
No visual loss 4. Facial Palsy: 2 - Partial paralysis (lower face) 5a. Motor Arm - Left: 3 - No
effort against gravity 5b. Motor Arm - Right: 0 - No drift 6a. Motor Leg - Left: 3 - No effort
against gravity 6b. Motor Leg - Right: 0 - No drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 1 -
Mild-to-moderate sensory loss 9. Best Language: 0 - No aphasia 10. Dysarthria: 1 - Mild-to-
moderate dysarthria 11. Extinction/Inattention: 0 - No abnormality
Total Score: 11/42
Scoring Notes: Patient 2 demonstrates a classic right hemisphere stroke presentation with left-
sided deficits. The gaze palsy (1) reflects impaired eye movement toward the left. Left arm and
, 2
leg both score 3, indicating hemiplegia without any effort against gravity. Facial palsy (2) is
partial, affecting primarily the lower left face. Dysarthria (1) and mild sensory loss (1) are
consistent with right hemisphere involvement. The absence of aphasia supports right hemisphere
localization.
PATIENT 3
NIHSS Item Scores: 1a. LOC: 1 - Not alert but arousable (drowsy, requires verbal stimulation)
1b. LOC Questions: 1 - Answers one correctly (month, not age) 1c. LOC Commands: 2 -
Performs neither correctly 2. Best Gaze: 0 - Normal 3. Visual: 0 - No visual loss 4. Facial Palsy:
0 - Normal 5a. Motor Arm - Left: 0 - No drift 5b. Motor Arm - Right: 0 - No drift 6a. Motor Leg
- Left: 0 - No drift 6b. Motor Leg - Right: 0 - No drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 0 -
Normal 9. Best Language: 2 - Severe aphasia 10. Dysarthria: 2 - Severe dysarthria (untestable
due to aphasia) 11. Extinction/Inattention: 0 - No abnormality
Total Score: 6/42
Scoring Notes: Patient 3 presents with altered consciousness and severe language dysfunction
without significant motor deficits. The drowsiness (1a=1) and inability to follow commands
(1c=2) reflect reduced alertness. The severe aphasia (9=2) is the dominant finding—patient
cannot communicate effectively through speech or comprehension. Dysarthria is scored 2 as
"untestable" due to the overriding aphasia per NIHSS guidelines. This pattern suggests a
dominant hemisphere (left) stroke affecting language centers, possibly with some mass effect
causing drowsiness.
PATIENT 4
NIHSS Item Scores: 1a. LOC: 0 - Alert 1b. LOC Questions: 0 - Answers both correctly 1c. LOC
Commands: 0 - Performs both tasks correctly 2. Best Gaze: 0 - Normal 3. Visual: 2 - Complete
hemianopia (left visual field) 4. Facial Palsy: 0 - Normal 5a. Motor Arm - Left: 0 - No drift 5b.
Motor Arm - Right: 0 - No drift 6a. Motor Leg - Left: 0 - No drift 6b. Motor Leg - Right: 0 - No
drift 7. Limb Ataxia: 0 - Absent 8. Sensory: 0 - Normal 9. Best Language: 0 - No aphasia 10.
Dysarthria: 0 - Normal 11. Extinction/Inattention: 2 - Profound hemi-inattention (left-sided)
Total Score: 4/42
Scoring Notes: Patient 4 demonstrates isolated right hemisphere dysfunction with complete left
hemianopia (2) and profound left-sided neglect/inattention (2). The visual field loss is complete,
not partial. The extinction/inattention score of 2 reflects severe neglect where the patient fails to
recognize or attend to left-sided stimuli despite intact primary sensory pathways. This pattern is
