SIH Score vs NIHSS Calculator

This easy to use, predictive scoring system is based on the six most relevant brain MRI findings and allows to assess the likelihood of a spinal cerebrospinal fluid (CSF) leak in patients with spontaneous intracranial hypotension (SIH). The scoring system may help headache specialists objectively predict the probability of an underling spinal cerebrspinal fluid leak. It is useful to triage patients who may benefit from more invasive myleographic examinations. Spontaneous intracranial hypotension Spontaneous intracranial hypotension (SIH) is an increasingly recognized disorder usually presenting with disabling orthostatic headache, which manifests within minutes after assuming the upright position, and subsides after lying down. According to the common doctrine SIH is triggered by CSF leakage from the intrathecal into the epidural compartment, which is usually due to an osteodiscogenic microspur (calcified disc protrusion or spondylophyte) penetrating the dura, or a leaky spinal nerve root diverticulum. Imaging plays a crucial role in the diagnostic work-up of SIH patients, but many challenges remain, particularly with respect to finding evidence of intracranial hypotension on brain MRI, and identifying and localizing a cerebrospinal fluid (CSF) leak.

NIHSS Calculator is a fast, accurate, and beautifully designed NIH Stroke Scale scoring tool, built for neurologists, stroke physicians, emergency doctors, nursing staff, and medical students working in acute stroke care. Designed by Dr Atif Elnil (MBBS MRCP, Stroke Unit St George's Hospital London UK), this app brings the complete 15-item NIHSS to your pocket with a clean, intuitive interface optimised for use at the bedside, in the emergency department, and on the stroke ward. WHAT'S INCLUDED All 15 NIHSS items scored in full: • 1a — Level of consciousness • 1b — LOC questions (month and age) • 1c — LOC commands (eyes and hand) • 2 — Best gaze • 3 — Visual fields • 4 — Facial palsy • 5a/5b — Motor arm (left and right, scored separately) • 6a/6b — Motor leg (left and right, scored separately) • 7 — Limb ataxia • 8 — Sensory • 9 — Best language (aphasia) • 10 — Dysarthria • 11 — Extinction and inattention INSTANT SEVERITY GRADING The total score updates in real time as you score each item, with immediate severity classification: • 0 — No stroke symptoms • 1–4 — Minor stroke • 5–10 — Moderate stroke • 11–15 — Moderate-severe stroke • 16–20 — Severe stroke • 21–42 — Very severe stroke DESIGNED FOR CLINICAL USE • Large, touch-friendly response buttons optimised for use with gloves or in a hurry • Progress indicator shows how many items have been scored • One-tap reset to start a new patient assessment • Works fully offline — no internet connection required • No login, no account, no data collected WHO IS THIS FOR? • Stroke physicians and neurologists • Emergency medicine doctors • Acute stroke nursing staff • Stroke specialist nurses and ANPs • Medical students on neurology and emergency placements • Paramedics and pre-hospital teams IMPORTANT NOTICE NIHSS Calculator is a clinical decision-support tool for use by qualified healthcare professionals. It does not recommend for or against thrombolysis or thrombectomy. All clinical decisions must be made by a qualified clinician using full clinical assessment and local guidelines. This application is intended for educational and informational purposes only. It is not a substitute for professional clinical judgment, local guidelines, or specialist advice. Always follow institutional protocols and consult appropriate medical professionals when making treatment decisions.