NIH Stroke Scale (NIHSS)

Miisaanka Kiharuska ee Machadka Qaranka ee Caafimaadka (National Institutes of Health)

Wadarta Dhibcaha: 0 / 42

Calaamado ma jiraan

1a. Heerka Miyir-qabka (Level of Consciousness)

Baaraha waa inuu doortaa jawaab, xitaa haddii qiimeyn buuxda ay carqaladeeyaan waxyaabo sida tuubbo endotracheal ah, xannibaad luqadeed, ama dhaawac wejiga.

0 — Miyir buuxa; ku jawaabaya si degdeg ah

1 — Miyir buuxa ma laha; kaqaadi kara kicin yar si uu u addeeco, u jawaabo, ama u falceliyo

2 — Miyir buuxa ma laha; u baahan kicin dib-u-celis ah ama kicin xanuun leh si uu u sameeyo dhaqdhaqaaqyo aan caadi ahayn

3 — Miyir-la'aan (Coma): kuma jawaabo waxaan ahayn falcelin dhaqdhaqaaq ama tuke ah, ama gabi ahaanba ma jawaabo

1b. Su'aalaha Miyir-qabka (LOC Questions)

Bukaanka (patient) weydii bisha hadda socota iyo da'diisa. Jawaabtu waa inay saxaad ahaataa — dhibco laguma siiyo jawaab u dhow. Bukaannada aphasia-ga ama miyirla'aanta qaba oo aan fahmin su'aalaha waxay heli 2 dhibcood.

0 — Wuxuu si sax ah uga jawaabaa labada su'aalood

1 — Wuxuu si sax ah uga jawaabaa hal su'aal

2 — Midna si sax ah ugama jawaabo

1c. Amarrada Miyir-qabka (LOC Commands)

Bukaanka weydii inuu indhaha furo oo xiro, ka dibna gacanta aan curyaanka ahayn qabto oo sii daayo. Haddii gacmaha aan la isticmaali karin, ku beddel amar kale oo hal tallaabo ah.

0 — Wuxuu si sax ah u sameeyaa labada shaqo

1 — Wuxuu si sax ah u sameeyaa hal shaqo

2 — Midna si sax ah uma sameeyo

2. Fiirinta Ugu Fiican (Best Gaze)

Kaliya tijaabi dhaqdhaqaaqyada isha ee jidka toosan (horizontal). Dhaqdhaqaaqyada iskood u dhaca ama kuwa reflexive (oculocephalic) waa la aqbalaa. Tijaabinta caloric lama sameeyo.

0 — Caadi

1 — Curyaanimo qayb ah oo fiirinta ah: fiirintu ma caadiya hal ama labada isha, laakiin qallooc qasab ah ama curyaanimo dhan ma jirto

2 — Qallooc qasab ah ama curyaanimo dhan oo fiirinta ah oo aan la baabi'in karin habka oculocephalic

3. Goobaha Aragga (Visual Fields)

Tijaabi qaybaha kore iyo hoose ee aragga adigoo isticmaalaya tirinta faraha ama hanjabaad muuqata. Haddii bukaanku u jeeso dhinaca kicinta muuqata, tan waxaa lagu qeexi karaa caadi.

0 — Aragga waa caadi

1 — Hemianopia qayb ah

2 — Hemianopia dhan

3 — Indha-la'aan labada dhinac (oo ay ku jirto indha-la'aanta cortical-ka)

4. Curyaanka Wejiga (Facial Palsy)

Weydii ama isticmaal calaamado si bukaanku u muujiyo ilkihiisa ama u dhoola caddeeyo oo indhaha xiro. Bukaannada aan si fiican u jawaabin, qiimee isku-dheelitirka dhaqdhaqaaqa wejiga ee ka dhasha kicinta xanuunka.

0 — Dhaqdhaqaaq caadi oo isku-dheelitiran

1 — Curyaanimo yar (laf-dhoolku fidsan yahay, khilaaf dhacaya markuu dhoola caddeeyo)

2 — Curyaanimo qayb ah (curyaanimo dhan ama ku dhow oo ku taal wejiga hoose)

3 — Curyaanimo dhan (dhaqdhaqaaq lagama arko wejiga sare iyo kan hoose)

5a. Dhaqdhaqaaqa — Gacanta Bidix

Sameyso xubinta: 90° (haddii uu fadhiyo) ama 45° (haddii uu jiifo), calaacalaha hoos u jeeda. Bukaanka weydii inuu boosaska hayo 10 ilbiriqsi.

0 — Ma dhicin; wuxuu haystaa boosaska 10 ilbiriqsi

1 — Dhac ka dhaca ka hor 10 ilbiriqsi iyada oo aan sariirta taaban

2 — Dadaal xoogaa ah oo ka dhan ah cuf-jiidka laakiin ma sii wadan karo boosaska

3 — Dadaal kama jiro oo ka dhan ah cuf-jiidka; xubintu way dhacdaa

4 — Dhaqdhaqaaq ma jiro

X — Lama tijaabin karo (gooye ama xidhka lafaha) — lama xisaabtamin

5b. Dhaqdhaqaaqa — Gacanta Midig

Sameyso xubinta: 90° (haddii uu fadhiyo) ama 45° (haddii uu jiifo), calaacalaha hoos u jeeda. Bukaanka weydii inuu boosaska hayo 10 ilbiriqsi.

0 — Ma dhicin; wuxuu haystaa boosaska 10 ilbiriqsi

1 — Dhac ka dhaca ka hor 10 ilbiriqsi iyada oo aan sariirta taaban

2 — Dadaal xoogaa ah oo ka dhan ah cuf-jiidka laakiin ma sii wadan karo boosaska

3 — Dadaal kama jiro oo ka dhan ah cuf-jiidka; xubintu way dhacdaa

4 — Dhaqdhaqaaq ma jiro

X — Lama tijaabin karo (gooye ama xidhka lafaha) — lama xisaabtamin

6a. Dhaqdhaqaaqa — Lugta Bidix

Bukaanku had iyo jeer wuxuu ku jiraa boos jiif ah. Lugta u dhig 30°. Bukaanka weydii inuu boosaska hayo 5 ilbiriqsi.

0 — Ma dhicin; wuxuu haystaa boosaska 5 ilbiriqsi

1 — Dhac ka dhaca ka hor 5 ilbiriqsi iyada oo aan sariirta taaban

2 — Dadaal xoogaa ah oo ka dhan ah cuf-jiidka; sariirta wuu taabtaa gudaha 5 ilbiriqsi

3 — Dadaal kama jiro oo ka dhan ah cuf-jiidka; xubintu isla markiiba way dhacdaa

4 — Dhaqdhaqaaq ma jiro

X — Lama tijaabin karo (gooye ama xidhka lafaha) — lama xisaabtamin

6b. Dhaqdhaqaaqa — Lugta Midig

Bukaanku had iyo jeer wuxuu ku jiraa boos jiif ah. Lugta u dhig 30°. Bukaanka weydii inuu boosaska hayo 5 ilbiriqsi.

0 — Ma dhicin; wuxuu haystaa boosaska 5 ilbiriqsi

1 — Dhac ka dhaca ka hor 5 ilbiriqsi iyada oo aan sariirta taaban

2 — Dadaal xoogaa ah oo ka dhan ah cuf-jiidka; sariirta wuu taabtaa gudaha 5 ilbiriqsi

3 — Dadaal kama jiro oo ka dhan ah cuf-jiidka; xubintu isla markiiba way dhacdaa

4 — Dhaqdhaqaaq ma jiro

X — Lama tijaabin karo (gooye ama xidhka lafaha) — lama xisaabtamin

7. Ataxia-ga Xubinta (Limb Ataxia)

Qiimeeya caddaynta nabar cerebellar dhinac keliya ah. Tijaabi indhaha furan. Haddii uu jiro nabar aragga ah, ku tijaabi goobta aragga ee caafimaadka qaba. Qiimee tijaabooyinka far-san-far iyo cedhib-lugleey labada dhinac.

0 — Ma jiro

1 — Ku jira hal xubin

2 — Ku jira laba xubnood

X — Lama tijaabin karo (gooye ama xidhka lafaha) — lama xisaabtamin

8. Dareenka (Sensory)

Ku tijaabi qalinka-dhalada ama kaqaadista kicinta xanuunka bukaannada dareenkoodu hoos u dhacay ama aphasia-ga qaba. Kaliya lumidda dareenka ee la xiriirta kiharuska ayaa la xisaabtamaa. Tijaabi wejiga, gacmaha, jirka, iyo lugaha.

0 — Caadi; lumid dareen ma jirto

1 — Lumid dareen oo yar-wax dhexdhexaad ah: bukaanku wuxuu dareemaa in qalinka-dhalada uu ka fiicnaan yahay dhinaca la saameeyay, laakiin waa ogyahay in la taabtay

2 — Lumid dareen daran ilaa buuxda: bukaanku ma ogaan karo in la taabtay wejiga, gacanta, iyo lugta

9. Luqadda Ugu Fiican (Best Language)

Bukaanka weydii inuu sharaxo sawir, magacaabo walxo ku yaal xaashi magacaabid, oo ka akhriyo liiska jumlado. Fahamka waxaa laga qiimeeyaa jawaabahan iyo amarradii hore lagu qiimeeyay.

0 — Aphasia ma jirto; caadi

1 — Aphasia yar-wax dhexdhexaad ah: lumid fasaxid ama fahamid, iyada oo aan si weyn u xaddidin fikradaha la muujinayo

2 — Aphasia daran: isgaarsiin jajaban; ku-tiirsanaan weyn oo ku salaysan fikirasho iyo mala-awaal ay sameeyo baaraha

3 — Aamusnaan ama aphasia guud: hadal la isticmaali karo ama fahamka dhagaysiga ma jiro

10. Dysarthria

Ka hel muunad hadal adigoo bukaanka weydiinaya inuu akhriyo ama ku celceliyo erayo ka mid ah liis caadi ah. Bukaannada aphasia-ga daran qaba, qiimee dhawaaqidda hadalka iskood u dhaca.

0 — Caadi

1 — Dysarthria yar-wax dhexdhexaad ah: erayada wuu qallajiyaa laakiin dhib xoogaa ah ayaa lagu fahmi karaa

2 — Dysarthria daran: hadalku lama fahmi karo ama waa aamus/anarthric, taasoo aan la habsaanayn aphasia haddii uu jiro

X — La geliyay tuubbo ama caqabad jireed kale — lama xisaabtamin

11. Extinction iyo Fiiro-la'aan (Neglect)

Macluumaad ku filan ayaa laga heli karaa tijaabooyinkii hore. Haddii bukaanku qabo lumid aragti oo daran oo ka hortagaya kicin arag laba-jibaaran, dareenka maqaarkuna caadi yahay, dhibcuhu waa 0.

0 — Wax aan caadi ahayn ma jiro

1 — Fiiro-la'aan ama extinction hal dareen ah (arag, taabasho, maqal, meel, ama shakhsi)

2 — Fiiro-la'aan dhinac-badan oo daran ama extinction dareen ka badan hal ah; ma aqoonsan gacantiisa ama wuxuu u jeedaa kaliya hal dhinac oo meel ah

Fasiraadda

Dooro ikhtiyaarrada kore si aad u xisaabiso dhibcaha NIHSS.

Kala Soocidda Ba'idda Kiharuska

Dhibcaha NIHSS	Ba'idda
0	Calaamado kiharusi ma jiraan
1 – 4	Kiharusi yar
5 – 15	Kiharusi dhexdhexaad ah
16 – 20	Kiharusi dhexdhexaad ilaa daran
21 – 42	Kiharusi daran

Fiiro gaar ah: NIHSS waa aalad la xaqiijiyay oo lagu qiimeeyo ba'idda kiharuska ischemic-ka ee degdegga ah, iyadoo dhibcuhu ka bilaabmayaan 0 ilaa 42. Waxaa loo isticmaalaa qiimeynta ugu horeysa, la socodka horumarka neerfaha, iyo qiyaasidda mustaqbalka bukaanka. Go'aanka ku saabsan daawaynta reperfusion-ka waa mid dhinacyo badan leh oo aan lagu salayn karin dhibcaha NIHSS oo kaliya. Aaladan lama beddelo qiimeyn caafimaad oo shakhsi ahaaneed.

Ilaha

1. Brott T, Adams HP Jr, Olinger CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864–870. PubMed ↗
2. Powers WJ, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update. Stroke. 2019;50(12):e344–e418. PubMed ↗

Calculamedica

NIH Stroke Scale (NIHSS)

1a. Heerka Miyir-qabka (Level of Consciousness)

1b. Su'aalaha Miyir-qabka (LOC Questions)

1c. Amarrada Miyir-qabka (LOC Commands)

2. Fiirinta Ugu Fiican (Best Gaze)

3. Goobaha Aragga (Visual Fields)

4. Curyaanka Wejiga (Facial Palsy)

5a. Dhaqdhaqaaqa — Gacanta Bidix

5b. Dhaqdhaqaaqa — Gacanta Midig

6a. Dhaqdhaqaaqa — Lugta Bidix

6b. Dhaqdhaqaaqa — Lugta Midig

7. Ataxia-ga Xubinta (Limb Ataxia)

8. Dareenka (Sensory)

9. Luqadda Ugu Fiican (Best Language)

10. Dysarthria

11. Extinction iyo Fiiro-la'aan (Neglect)

Fasiraadda

Kala Soocidda Ba'idda Kiharuska