Canadian Neurological Scale

Changed by Craig Hacking, 20 Oct 2020

Updates to Article Attributes

Body was changed:

The Canadian Neurological Scale is a validated tool to evaluate stroke severity 1,2 designed to be performed on patients who are alert or drowsy. Patients who are stuporous or comatose are evaluated with the Glasgow Coma Scale (GCS) instead.

Classification

Section A is completed first. In the second part of the scale calculation, either section A1 or A2 is completed depending on whether a comprehension deficit is present or not. 

Section A – patient alert or drowsy
Mentation
  • level of consciousness: alert (3), drowsy (1.5)
  • orientation: oriented (1), disoriented or non-applicable (0)
  • speech: normal (1), expressive deficit(0.5), receptive deficit (0)
Section A1 – no comprehension deficit
Motor weakness
  • face: none (0.5), present (0)
  • arm proximal: none (1.5), mild (1), significant (0.5), total (0)
  • arm distal: none (1.5), mild (1), significant (0.5), total (0)
  • leg: none (1.5), mild (1), significant (0.5), total (0)
Section A2 - comprehension deficit
Motor response
  • face: symmetrical (0.5), asymmetrical (0)
  • arms: equal (1.5), unequal (0)
  • legs: equal (1.5), unequal (0)
Section B – patient stuporous or comatose

Interpretation

Scores range from 1.5 to 11.5, with a lower score indicating greater stroke severity.

Practical points

The Canadian Stroke Scale can be converted 3 to the National Institutes of Health Stroke Scale (NIHSS) using NIHSS = 23 - 2 x CNS

  • -style='mso-element:field-separator'></span><![endif]--><sup>1,2 </sup>designed to be performed on patients who are alert or drowsy. Patients who are stuporous or comatose are evaluated with the <a href="/articles/glasgow-coma-scale-1">Glasgow Coma Scale (GCS)</a> instead.</p><p><strong style="font-size:1.5em; font-weight:bold">Classification</strong></p><p>Section A is completed first. In the second part of the scale calculation, either section A1 or A2 is completed depending on whether a comprehension deficit is present or not. </p><h5>Section A – patient alert or drowsy</h5><h6>Mentation</h6><ul>
  • +style='mso-element:field-separator'></span><![endif]--><sup>1,2 </sup>designed to be performed on patients who are alert or drowsy. Patients who are stuporous or comatose are evaluated with the <a href="/articles/glasgow-coma-scale-1">Glasgow Coma Scale (GCS)</a> instead.</p><h4>Classification</h4><p>Section A is completed first. In the second part of the scale calculation, either section A1 or A2 is completed depending on whether a comprehension deficit is present or not. </p><h5>Section A – patient alert or drowsy</h5><h6>Mentation</h6><ul>
  • -</ul><h5>Section B – patient stuporous or comatose</h5><ul><li>use <a title="GCS" href="/articles/glasgow-coma-scale-1">GCS</a>
  • -</li></ul><h4>Interpretation</h4><p>Scores range from 1.5 to 11.5, with a lower score indicating greater stroke severity.</p><h4>Practical points</h4><p>The Canadian Stroke Scale can be converted <sup>3</sup> to the <a href="/articles/national-institutes-of-health-stroke-scale-nihss-2">National Institutes of Health Stroke Scale</a><a title="National Institutes of Health Stroke Scale (NIHSS)" href="/articles/national-institutes-of-health-stroke-scale-nihss-2"> (NIHSS)</a> using NIHSS = 23 - 2 x CNS</p>
  • +</ul><h5>Section B – patient stuporous or comatose</h5><ul><li>use <a href="/articles/glasgow-coma-scale-1">GCS</a>
  • +</li></ul><h4>Interpretation</h4><p>Scores range from 1.5 to 11.5, with a lower score indicating greater stroke severity.</p><h4>Practical points</h4><p>The Canadian Stroke Scale can be converted <sup>3</sup> to the <a href="/articles/national-institutes-of-health-stroke-scale-nihss-2">National Institutes of Health Stroke Scale</a><a href="/articles/national-institutes-of-health-stroke-scale-nihss-2"> (NIHSS)</a> using NIHSS = 23 - 2 x CNS</p>

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