Apple / medical / NIH STROKE SCALE CALCULATOR
REVIEW
The NIH Stroke Scale Calculator turns a paper protocol into a bedside tool.
A pocket implementation of the standardised neurological assessment used in every stroke unit in the world.
BY THE APP COMRADE DESK · MAY 11, 2026 · 4 MIN READ
NIH Stroke Scale Calculator
US DEPARTMENT OF VETERANS AFFAIRS (VA)
OUR SCORE
8.0
APPLE
★ 5.0
PRICE
Free
The NIH Stroke Scale is the closest thing acute neurology has to a universal language. Every stroke unit in the United States, every randomised tPA trial since NINDS, every transfer note out of a community ED to a comprehensive stroke center — they all speak NIHSS. The scale is fifteen years older than the iPhone, and it was designed to be administered with a clipboard, a penlight, and a stack of laminated stimulus cards.
The NIH Stroke Scale Calculator does the obvious thing well. It puts the eleven items on a phone, tallies the score, and stays out of the clinician’s way. There is no onboarding flow, no subscription paywall, no analytics screen — just the scale, in order, with the published wording.
That restraint is the review. A bedside scoring tool either matches the validated instrument exactly or it’s a liability, and this one matches it.
The NIHSS is the lingua franca of acute stroke care, and a calculator that does only that — quickly, correctly — is exactly the tool the workflow asks for.
FEATURES
The app walks through the eleven NIHSS items in their canonical order — level of consciousness, gaze, visual fields, facial palsy, motor arm and leg (scored per side), limb ataxia, sensory, best language, dysarthria, extinction and inattention — and totals the score as you tap. Each item shows the standard 0–4 (or 0–2/0–3) options with the published descriptors, so a clinician scoring at the bedside can read the exact wording the scale was validated against rather than paraphrasing from memory.
Tapping back into any item to change a score updates the running total live. The interface is single-screen scrollable, which matters: stroke assessments happen in the middle of a code stroke clock, often with one hand on the patient and the other on the phone. There is a reference view that displays the full scoring rubric for each item, and the final total renders with the standard severity bands — minor (1–4), moderate (5–15), moderate to severe (16–20), severe (21–42) — alongside the score.
No accounts, no cloud sync, no patient identifiers stored. The app works fully offline, which is the only correct design choice for something a clinician will use in a CT suite or an ambulance bay where coverage is unreliable.
MISSION ACCOMPLISHED
The wording on every item matches the published NIHSS exactly. That sounds basic, but a meaningful fraction of "stroke scale" apps on the App Store paraphrase the descriptors in ways that subtly shift the score — usually toward overscoring distal weakness or underscoring aphasia. This one doesn't. A nurse or resident scoring with the app gets the same number as a stroke fellow scoring with the paper form.
The other thing it gets right is restraint. There's no attempt to bolt on a tPA eligibility checker, a door-to-needle timer, or a teaching module. The NIHSS is the lingua franca of acute stroke care, and a calculator that does only that — quickly, correctly — is exactly the tool the workflow asks for.
ROOM TO IMPROVE
There's no way to save or export a completed assessment, which matters more than it sounds. Stroke teams routinely re-score at 24 hours and at discharge to track delta — the app makes you re-enter every item from scratch each time, with no patient label and no history. A simple "save as note" that exports a plain-text NIHSS line item with timestamp would close the loop without touching PHI.
The reference rubric is text-only. The actual NIHSS includes standardised stimulus cards — the cookie-theft picture for aphasia, the sentence-reading card, the naming sheet. The app should ship those cards as in-app images so the whole exam can run from one device. Right now you still need the paper stimuli or a second app to administer the language items correctly.
CONCLUSION
Install it if you score stroke patients for a living — neurology residents, ED attendings, stroke nurses, EMS clinicians running a Cincinnati-to-NIHSS handoff. Skip it if you want a teaching tool: this is a calculator, not a course. Watch for stimulus cards and a saved-assessment export in future versions; both would move it from useful to essential.