STROKESCA
411-STROKE
SCALE
ANSWERS,
LATEST
UPDATED
2025/26
, AttemptLHistory
Hernandez,LDelmy
01LNIHSSEnglishLGroupLAV3L 1stLCertification
Date Result
3/3/2018L4:12:38LAM Passed 89LofL90L (98.89L%) ViewLResponses
PatientL 1
Topic Question Answer Grade
LevelLofLConsci 1a.LLevelLofLConsciousn 0L=LAlert;LkeenlyLresponsive Correct
ousness ess:LTheLinvestigatorLm
ustLchooseLaLresponse,Le
venLifLaLfullLevaluationLis
LpreventedLbyLsuchLobst
aclesLasLanLendotrachea
lLtube,LlanguageLbarrier
,LorotrachealLtrauma/ba
ndages.LAL3LisLscoredLonl
yLifLtheLpatientLmakesLn
oLmovementL(otherLtha
nLreflexiveLposturing)Lin
LresponseLtoLnoxiousLsti
mulation.
LOCLQuestions 1b.LLOCL Questions:LThe 0L=LAnswersLbothLquestionsL Correct
patientLisLaskedLtheLmo correctly
nthLandLhis/herLage.LTh
eLanswerLmustLbeLcorre
ctLthereLisLnoLpartialLcre
ditLforLbeingLclose.LAph
asicLandLstuporousLpati
entsLwhoLdoLnotLcompre
hendLtheLquestionsLwillL
scoreL2.LPatientsLunableL
toLspeakLbecauseLofLend
otrachealLintubation,Lor
otrachealLtrauma,Lsever
eLdysarthriaLfromLanyLc
ause,LlanguageLbarrierL
orLanyLotherLproblemLn
otLsecondaryLtoLaphasia
LareLgivenLaL1.LItLisLimpor
tantLthatLonlyLtheLinitialL
answerLbeLgradedLandLt
hatLtheLexaminerLnotL"h
elp"LtheLpatientLwithLver
balLorLnonverbalLcues.
LOCLCommands 1c.L LOCL Commands: 0L=LPerformsLbothLtasksLcorrectlyLCorrect
TheLpatientLisLaskedLtoL
openLandLcloseLtheLeyesL
andLthenLtoLgripLand
, releaseLtheLnonpareticL
hand.LSubstituteLanoth
erLoneLstepLcommandLif
LtheLhandsLcannotLbeLus
ed.LCreditLisLgivenLifLanL
unequivocalLattemptLisL
madeLbutLnotLcompleted
LdueLtoLweakness.LIfLthe
LpatientLdoesLnotLrespo
ndLtoLcommand,LtheLtas
kLshouldLbeLdemonstrat
edLtoLthemL(pantomime
)LandLscoreLtheLresultL(i.
e.,LfollowsLnone,LoneLorL
twoLcommands).LPatien
tsLwithLtrauma,Lamputa
tion,LorLotherLphysicalLi
mpedimentsLshouldLbeLg
ivenLsuitableLonestepLco
mmands.
OnlyLtheLfirstL attemptL is
scored.
BestLGaze
2.LBestLGaze:LOnl
yLhorizontalLeyeLmove 0L=LNormal Correct
mentsLwillLbeLtested.Vol
untaryLorLreflexiveL(ocul
ocephalic)LeyeLmoveme
ntsLwillLbeLscoredLbutLc
aloricLtestingLisLnotLdon
e.LIfLtheLpatientLhasLaLc
onjugateLdeviationLofLth
eLeyesLthatLcanLbeLover
comeLbyLvoluntaryLorLre
flexiveLactivity,LtheLscor
eLwillLbeL1.LIfLaLpatientL
hasLanLisolatedLperipher
alLnerveLparesisL(CNLIII,L
IVLorLVI)LscoreLaL1.LGaz
eLisLtestableLinLallLaphas
icLpatients.
PatientsLwithLocular
trauma,Lbandages,Lpre
LexistingLblindnessLorLo
therLdisorderLofLvisualL
acuityLorLfieldsLshouldL
beLtestedLwithLreflexiveL
movementsLandLaLchoi
ceLmadeLbyLtheLinvesti
gator.
EstablishingLeyeLcontactL
andLthenLmovingLaboutL
theLpatientLfromLsideLtoL
sideLwillLoccasionally
, clarifyLtheLpresenceLofLaL
partialLgazeLpalsy.
Visual 0L=LNoLvisualLloss Correct
3.LVisual:LVisualLfi
eldsL(upperLandLlowerLq
uadrants)LareLtestedLbyLc
onfrontation,LusingLfing
erLcountingLorLvisualLthr
eatLasLappropriate.
PatientLmustLbeLencour
aged,LbutLifLtheyLlookLat
LtheLsideLofLtheLmovingL
fingersLappropriately,Lt
hisLcanLbeLscoredLasLnor
mal.LIfLthereLisLunilater
alLblindnessL orLenucleati
on,LvisualLfieldsLinLtheLre
mainingLeyeLareLscored.L
ScoreL1LonlyLifLaLclearcut
Lasymmetry,LincludingLq
uadrantanopiaLisLfound.
LIfLpatientLisLblindLfromLa
nyLcauseLscoreL3.LDoubl
eLsimultaneousLstimulat
ionLisLperformedLatLthisL
point.LIfLthereLisLextincti
onLpatientLreceivesLaL1,L
andLtheLresultsLareLused
LtoLanswerLquestionL11.
FacialLPalsy 0L=LNormalLsymmetrical Correct
4.LFacialLPalsy:LAs Lmovement
k,LorLuseLpantomimeLtoL
encourageLtheLpatientLto
LshowLteethLorLraiseLeye
browsLandLcloseLeyes.LS
coreLsymmetryLofLgrima
ceLinLresponseLtoLnoxiou
sLstimuliLinLtheLpoorlyLre
sponsiveLorLnoncompre
hendingLpatient.LIfLfacia
lLtrauma/bandages,Lorot
rachealLtube,LtapeLorLot
herLphysicalLbarriersLob
scureLtheLface,LtheseLsh
ouldLbeLremovedLtoLtheL
extentLpossible.
MotorL Arms 5a.LMotorLArmLLeft:LThe
limbLisLplacedLinLtheLapp 0L=LNoLdrift,LlimbLholdsL90L(orL Incorrect
ropriateLposition:Lexten 45)LdegreesLforLfullL10Lseconds
dLtheLarmsL(palmsLdown
)L90LdegreesL(ifLsitting)L
orL45LdegreesL(ifLsupine)
.LDriftLisLscoredLif
411-STROKE
SCALE
ANSWERS,
LATEST
UPDATED
2025/26
, AttemptLHistory
Hernandez,LDelmy
01LNIHSSEnglishLGroupLAV3L 1stLCertification
Date Result
3/3/2018L4:12:38LAM Passed 89LofL90L (98.89L%) ViewLResponses
PatientL 1
Topic Question Answer Grade
LevelLofLConsci 1a.LLevelLofLConsciousn 0L=LAlert;LkeenlyLresponsive Correct
ousness ess:LTheLinvestigatorLm
ustLchooseLaLresponse,Le
venLifLaLfullLevaluationLis
LpreventedLbyLsuchLobst
aclesLasLanLendotrachea
lLtube,LlanguageLbarrier
,LorotrachealLtrauma/ba
ndages.LAL3LisLscoredLonl
yLifLtheLpatientLmakesLn
oLmovementL(otherLtha
nLreflexiveLposturing)Lin
LresponseLtoLnoxiousLsti
mulation.
LOCLQuestions 1b.LLOCL Questions:LThe 0L=LAnswersLbothLquestionsL Correct
patientLisLaskedLtheLmo correctly
nthLandLhis/herLage.LTh
eLanswerLmustLbeLcorre
ctLthereLisLnoLpartialLcre
ditLforLbeingLclose.LAph
asicLandLstuporousLpati
entsLwhoLdoLnotLcompre
hendLtheLquestionsLwillL
scoreL2.LPatientsLunableL
toLspeakLbecauseLofLend
otrachealLintubation,Lor
otrachealLtrauma,Lsever
eLdysarthriaLfromLanyLc
ause,LlanguageLbarrierL
orLanyLotherLproblemLn
otLsecondaryLtoLaphasia
LareLgivenLaL1.LItLisLimpor
tantLthatLonlyLtheLinitialL
answerLbeLgradedLandLt
hatLtheLexaminerLnotL"h
elp"LtheLpatientLwithLver
balLorLnonverbalLcues.
LOCLCommands 1c.L LOCL Commands: 0L=LPerformsLbothLtasksLcorrectlyLCorrect
TheLpatientLisLaskedLtoL
openLandLcloseLtheLeyesL
andLthenLtoLgripLand
, releaseLtheLnonpareticL
hand.LSubstituteLanoth
erLoneLstepLcommandLif
LtheLhandsLcannotLbeLus
ed.LCreditLisLgivenLifLanL
unequivocalLattemptLisL
madeLbutLnotLcompleted
LdueLtoLweakness.LIfLthe
LpatientLdoesLnotLrespo
ndLtoLcommand,LtheLtas
kLshouldLbeLdemonstrat
edLtoLthemL(pantomime
)LandLscoreLtheLresultL(i.
e.,LfollowsLnone,LoneLorL
twoLcommands).LPatien
tsLwithLtrauma,Lamputa
tion,LorLotherLphysicalLi
mpedimentsLshouldLbeLg
ivenLsuitableLonestepLco
mmands.
OnlyLtheLfirstL attemptL is
scored.
BestLGaze
2.LBestLGaze:LOnl
yLhorizontalLeyeLmove 0L=LNormal Correct
mentsLwillLbeLtested.Vol
untaryLorLreflexiveL(ocul
ocephalic)LeyeLmoveme
ntsLwillLbeLscoredLbutLc
aloricLtestingLisLnotLdon
e.LIfLtheLpatientLhasLaLc
onjugateLdeviationLofLth
eLeyesLthatLcanLbeLover
comeLbyLvoluntaryLorLre
flexiveLactivity,LtheLscor
eLwillLbeL1.LIfLaLpatientL
hasLanLisolatedLperipher
alLnerveLparesisL(CNLIII,L
IVLorLVI)LscoreLaL1.LGaz
eLisLtestableLinLallLaphas
icLpatients.
PatientsLwithLocular
trauma,Lbandages,Lpre
LexistingLblindnessLorLo
therLdisorderLofLvisualL
acuityLorLfieldsLshouldL
beLtestedLwithLreflexiveL
movementsLandLaLchoi
ceLmadeLbyLtheLinvesti
gator.
EstablishingLeyeLcontactL
andLthenLmovingLaboutL
theLpatientLfromLsideLtoL
sideLwillLoccasionally
, clarifyLtheLpresenceLofLaL
partialLgazeLpalsy.
Visual 0L=LNoLvisualLloss Correct
3.LVisual:LVisualLfi
eldsL(upperLandLlowerLq
uadrants)LareLtestedLbyLc
onfrontation,LusingLfing
erLcountingLorLvisualLthr
eatLasLappropriate.
PatientLmustLbeLencour
aged,LbutLifLtheyLlookLat
LtheLsideLofLtheLmovingL
fingersLappropriately,Lt
hisLcanLbeLscoredLasLnor
mal.LIfLthereLisLunilater
alLblindnessL orLenucleati
on,LvisualLfieldsLinLtheLre
mainingLeyeLareLscored.L
ScoreL1LonlyLifLaLclearcut
Lasymmetry,LincludingLq
uadrantanopiaLisLfound.
LIfLpatientLisLblindLfromLa
nyLcauseLscoreL3.LDoubl
eLsimultaneousLstimulat
ionLisLperformedLatLthisL
point.LIfLthereLisLextincti
onLpatientLreceivesLaL1,L
andLtheLresultsLareLused
LtoLanswerLquestionL11.
FacialLPalsy 0L=LNormalLsymmetrical Correct
4.LFacialLPalsy:LAs Lmovement
k,LorLuseLpantomimeLtoL
encourageLtheLpatientLto
LshowLteethLorLraiseLeye
browsLandLcloseLeyes.LS
coreLsymmetryLofLgrima
ceLinLresponseLtoLnoxiou
sLstimuliLinLtheLpoorlyLre
sponsiveLorLnoncompre
hendingLpatient.LIfLfacia
lLtrauma/bandages,Lorot
rachealLtube,LtapeLorLot
herLphysicalLbarriersLob
scureLtheLface,LtheseLsh
ouldLbeLremovedLtoLtheL
extentLpossible.
MotorL Arms 5a.LMotorLArmLLeft:LThe
limbLisLplacedLinLtheLapp 0L=LNoLdrift,LlimbLholdsL90L(orL Incorrect
ropriateLposition:Lexten 45)LdegreesLforLfullL10Lseconds
dLtheLarmsL(palmsLdown
)L90LdegreesL(ifLsitting)L
orL45LdegreesL(ifLsupine)
.LDriftLisLscoredLif
