Buendia, Bryan Pameniano

Divine World College of Legazpi

Bachelor of Science in Nursing III

Group: #7

Stroke

A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the
brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die.
A stroke can cause lasting brain damage, long-term disability, or even death.

Two Major Types

Ischemic stroke - occurs when blood clots or other particles block the blood vessels to the brain. Fatty
deposits called plaque can also cause blockages by building up in the blood vessels.

Hemorrhagic stroke - happens when an artery in the brain leaks blood or ruptures (breaks open). The
leaked blood puts too much pressure on brain cells, which damages them. High blood pressure and
aneurysms—balloon-like bulges in an artery that can stretch and burst—are examples of conditions that
can cause a hemorrhagic stroke.

Assessment Tool for Stroke

National Institutes of Health Stroke Scale

The NIHSS is a 15-item scale that standardizes and quantifies the basic neurological examination, paying
particular attention to those aspects most pertinent to stroke. The NIHSS provides an ordinal, nonlinear
measure of acute stroke-related impairments by assigning numerical values to various aspects of
neurological function (Brott et al., 1989; Harrison et al., 2013). The scale incorporates assessment of
language, motor function, sensory loss, consciousness, visual fields, extraocular movements,
coordination, neglect, and speech. It is scored from 0 (no impairment) to a maximum of 42. Scores of 21
or greater are usually described as “severe.” A standardized approach to assessment, starting with
fundamental assessments such as level of consciousness, is recommended, and guidance is given on how
to score where the stroke survivor is not able to respond to commands.

The NIHSS has many advantages as a stroke outcome-assessment tool. It is relatively straightforward and
takes around 6 minutes to perform, with no need for additional equipment. In the acute-stroke
environment, the NIHSS is well suited to serial measures of impairment (Adam ey al., 1999; Harrison et
al., 2013).

Table 1. National Institutes of Health Stroke Scale Form

S0URCE:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578502/#ref-list-1title

2. Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, Spilker J, Holleran R, Eberle R,
Hertzberg V, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989
Jul;20(7):864-70. doi: 10.1161/01.str.20.7.864. PMID: 2749846.
https://pubmed.ncbi.nlm.nih.gov/2749846/

3. Adams HP Jr, Davis PH, Leira EC, Chang KC, Bendixen BH, Clarke WR, Woolson RF, Hansen MD.
Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org
10172 in Acute Stroke Treatment (TOAST). Neurology. 1999 Jul 13;53(1):126-31. doi:
10.1212/wnl.53.1.126. PMID: 10408548. https://pubmed.ncbi.nlm.nih.gov/10408548/

4. https://www.cdc.gov/stroke/about.htm