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Rationale: Minor facial asymmetry with mild sensory impairment produces a low NIHSS burden without
motor, language, gaze, or neglect deficits.
Patient 5
1a. Level of Consciousness: 1 (Drowsy but arousable)
1b. LOC Questions: 1 (Answers one correctly)
1c. LOC Commands: 0 (Performs both tasks correctly)
2. Best Gaze: 1 (Partial gaze palsy)
3. Visual Fields: 1 (Partial hemianopia)
4. Facial Palsy: 2 (Partial paralysis)
5a. Motor Arm – Left: 2 (Some effort against gravity)
5b. Motor Arm – Right: 0 (No drift)
6a. Motor Leg – Left: 2 (Some effort against gravity)
6b. Motor Leg – Right: 0 (No drift)
7. Limb Ataxia: 1 (Present in one limb)
8. Sensory: 1 (Mild sensory loss)
9. Best Language: 1 (Mild-to-moderate aphasia)
10. Dysarthria: 1 (Mild-to-moderate dysarthria)
11. Extinction/Inattention: 1 (Inattention to one side)
Rationale: The combination of contralateral arm and leg weakness, gaze abnormality, visual-field loss,
facial weakness, and cortical deficits is consistent with a moderate hemispheric stroke.
Patient 6
1a. Level of Consciousness: 2 (Requires repeated stimulation)
1b. LOC Questions: 2 (Neither correct)
1c. LOC Commands: 1 (Performs one task correctly)
2. Best Gaze: 2 (Partial gaze deviation)
3. Visual Fields: 2 (Complete hemianopia)
4. Facial Palsy: 2 (Partial paralysis)
5a. Motor Arm – Left: 3 (No effort against gravity)
5b. Motor Arm – Right: 1 (Drift)
6a. Motor Leg – Left: 3 (No effort against gravity)
6b. Motor Leg – Right: 1 (Drift)
7. Limb Ataxia: 0 (Absent)
8. Sensory: 2 (Severe sensory loss)
9. Best Language: 2 (Severe aphasia)
10. Dysarthria: 2 (Severe dysarthria)
11. Extinction/Inattention: 2 (Profound neglect)
Rationale: Marked consciousness impairment, severe contralateral weakness, complete visual-field loss,
aphasia, sensory loss, and neglect indicate a severe hemispheric neurologic deficit.
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pg. 1
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pg. 2
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Rationale: Minor facial asymmetry with mild sensory impairment produces a low NIHSS burden without
motor, language, gaze, or neglect deficits.
Patient 5
1a. Level of Consciousness: 1 (Drowsy but arousable)
1b. LOC Questions: 1 (Answers one correctly)
1c. LOC Commands: 0 (Performs both tasks correctly)
2. Best Gaze: 1 (Partial gaze palsy)
3. Visual Fields: 1 (Partial hemianopia)
4. Facial Palsy: 2 (Partial paralysis)
5a. Motor Arm – Left: 2 (Some effort against gravity)
5b. Motor Arm – Right: 0 (No drift)
6a. Motor Leg – Left: 2 (Some effort against gravity)
6b. Motor Leg – Right: 0 (No drift)
7. Limb Ataxia: 1 (Present in one limb)
8. Sensory: 1 (Mild sensory loss)
9. Best Language: 1 (Mild-to-moderate aphasia)
10. Dysarthria: 1 (Mild-to-moderate dysarthria)
11. Extinction/Inattention: 1 (Inattention to one side)
Rationale: The combination of contralateral arm and leg weakness, gaze abnormality, visual-field loss,
facial weakness, and cortical deficits is consistent with a moderate hemispheric stroke.
Patient 6
1a. Level of Consciousness: 2 (Requires repeated stimulation)
1b. LOC Questions: 2 (Neither correct)
1c. LOC Commands: 1 (Performs one task correctly)
2. Best Gaze: 2 (Partial gaze deviation)
3. Visual Fields: 2 (Complete hemianopia)
4. Facial Palsy: 2 (Partial paralysis)
5a. Motor Arm – Left: 3 (No effort against gravity)
5b. Motor Arm – Right: 1 (Drift)
6a. Motor Leg – Left: 3 (No effort against gravity)
6b. Motor Leg – Right: 1 (Drift)
7. Limb Ataxia: 0 (Absent)
8. Sensory: 2 (Severe sensory loss)
9. Best Language: 2 (Severe aphasia)
10. Dysarthria: 2 (Severe dysarthria)
11. Extinction/Inattention: 2 (Profound neglect)
Rationale: Marked consciousness impairment, severe contralateral weakness, complete visual-field loss,
aphasia, sensory loss, and neglect indicate a severe hemispheric neurologic deficit.
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