Neurology Calculators

Identifies adults with minor head injury (GCS 13–15) who require CT head to detect clinically important brain injury or skull fracture. Applicable to patients with witnessed LOC, amnesia, or confusion.

Identifies adults with minor head injury (GCS = 15, LOC) who require CT head. More sensitive but less specific than Canadian CT Head Rule. ANY criterion positive → CT required.

Identifies alert, non-traumatic headache patients who are at risk for subarachnoid haemorrhage (SAH) and require investigation. ALL criteria must be absent to rule out SAH.

Predicts 30-day mortality in spontaneous intracerebral haemorrhage (ICH) using 5 clinical and radiological variables. Guides prognostication and goals-of-care discussions.

Predicts risk of symptomatic cerebral vasospasm after subarachnoid haemorrhage (SAH) based on CT appearance of blood distribution. Guides monitoring intensity.

Assesses degree of disability and functional independence after stroke or other neurological events. Standard outcome measure in stroke trials and rehabilitation.

Measures functional independence in activities of daily living (ADLs) in patients with neurological or physical disability. Score 0–100; higher = more independent.

Predicts risk of serious adverse events (arrhythmia, death, MI, structural heart disease) within 30 days of syncope presentation to ED. Guides admission vs safe discharge.

Corrects total phenytoin level for hypoalbuminaemia. Phenytoin is ~90% protein-bound — low albumin causes falsely low total levels. Used in epilepsy management and toxicity assessment.

Identifies ED patients with syncope at risk for serious outcomes within 7 days (arrhythmia, MI, PE, intracranial haemorrhage, death). ANY criterion positive = high risk.

Simplified 3-level assessment of motor response as a rapid screening tool for traumatic brain injury severity. Derived from the motor component of GCS.

Brief validated screening tool for cognitive impairment. 6 items assessing temporal orientation, counting backwards, and memory. Score 0–28; higher score = worse cognition.

Predicts functional independence (mRS ≤ 2) at 90 days after intracerebral haemorrhage (ICH). Used alongside ICH Score to guide treatment decisions and goals-of-care discussions.

15-item neurological assessment tool quantifying stroke severity. Guides thrombolysis eligibility and predicts outcome.

Predicts 2-day stroke risk after transient ischaemic attack. Guides urgency of investigation and admission.

Classifies subarachnoid haemorrhage severity based on clinical presentation. Predicts surgical risk and outcome.

Five low-risk criteria to exclude cervical spine injury without imaging in blunt trauma. All five must be met to clear c-spine.

Expanded Disability Status Scale for quantifying disability in multiple sclerosis. Ranges from 0 (normal) to 10 (death due to MS).

Assesses independence in 6 basic Activities of Daily Living (ADLs). Standard tool for functional assessment in elderly and post-acute care.

Estimates recurrence risk after a first unprovoked seizure to guide antiepileptic drug (AED) initiation discussion.

Predicts risk of symptomatic intracranial haemorrhage (sICH) after IV thrombolysis (rtPA) for ischaemic stroke.

Identifies ED syncope patients at risk of serious outcome within 7 days. Any criterion positive = high risk. CHESS mnemonic.

Identifies low-risk minor head injury patients who can avoid CT head. Applies to patients with GCS 15, loss of consciousness, and head trauma.

Brief cognitive screening test for dementia in primary care. Score 0–28; score ≥8 suggests significant cognitive impairment. Quick to administer (~3 minutes).

Clinical classification of multiple sclerosis phenotype based on disease course (RRMS, SPMS, PPMS, CIS) using the 2013 Lublin consensus criteria.

10-point CT scoring system for early ischaemic changes in the MCA territory. Lower score = more ischaemic damage. ASPECTS ≤7 associated with poor thrombolysis outcome.

Recognition of Stroke in the Emergency Room (ROSIER) scale. Validated tool to distinguish stroke from stroke mimics in the emergency department.

Field Assessment Stroke Triage for Emergency Destination (FAST-ED). Identifies large vessel occlusion (LVO) stroke for prehospital triage to thrombectomy-capable centre.

Combines the Glasgow Coma Scale with pupillary response to improve prediction of mortality and disability after traumatic brain injury. GCS-Pupils = GCS sum − Pupil Reactivity Score.

Head Impulse, Nystagmus, Test of Skew (HINTS). 3-step bedside eye examination to differentiate posterior fossa stroke from peripheral vestibular disorder in acute vestibular syndrome. More sensitive than early MRI.

Assesses level of consciousness in non-verbal or intubated patients. Scores eye response, motor response, brainstem reflexes, and respiration. Avoids limitations of the verbal GCS component.

Staging tool for dementia severity. Assesses memory, orientation, judgment/problem solving, community affairs, home/hobbies, and personal care. CDR-Sum of Boxes (CDR-SB) gives more granular staging.

Stages severity of Parkinson's disease from Stage 0 (no signs) to Stage 5 (wheelchair-bound). Modified version adds 1.5 and 2.5 intermediate stages.

Migraine Disability Assessment questionnaire measures days of disability from migraines in the past 3 months across work, household, and social domains. Guides treatment intensity.

Checklist of absolute and relative contraindications to IV alteplase (tPA) for acute ischaemic stroke. Any absolute contraindication = tPA not indicated.

Differentiates reversible cerebral vasoconstriction syndrome (RCVS) from primary central nervous system vasculitis (PCNSV). Score ≥5 = RCVS likely (sensitivity 90%, specificity 99%).

Myasthenia Gravis Foundation of America (MGFA) clinical classification for myasthenia gravis. Guides prognosis and treatment intensity. Distinguishes ocular from generalised MG.

Predicts functional outcome 3 months after IV tPA for ischaemic stroke. Score 0–1 = good outcome >95%. Score 8–10 = poor outcome >96%.

International Panel on Diagnosis of Multiple Sclerosis 2017 Revised McDonald Criteria. Used to diagnose MS based on demonstration of dissemination in space (DIS) and dissemination in time (DIT) using clinical attacks and MRI findings. Incorporates CSF oligoclonal bands to substitute for DIT in some scenarios. Published by Thompson et al. 2018.

Validated ICU-specific delirium assessment tool. Based on the DSM criteria for delirium adapted for use in non-verbal, intubated ICU patients. Requires RASS (Richmond Agitation-Sedation Scale) score above -3 for valid assessment. CAM-ICU positive indicates delirium. Validated by Ely et al. 2001 in 96 ICU patients. Sensitivity 95-100%, specificity 89-93%. NICE and SCCM guidelines recommend routine delirium screening in all ICU patients.

ASTRAL (Acute STroke Registry and Analysis of Lausanne) score predicts unfavourable functional outcome (modified Rankin Scale 3-6) at 3 months after ischaemic stroke. Based on 6 variables assessed at admission. Score 0-50; higher score = worse outcome. AUC 0.85 for predicting poor outcome. Validated by Ntaios et al. 2012 in 1,645 patients. Useful for early prognostication and goals of care discussions.

Los Angeles Motor Scale (LAMS). Prehospital and emergency department tool for rapid assessment of stroke severity and identification of Large Vessel Occlusion (LVO). Three components: facial droop, arm drift, and grip strength. Score 0-5; score above 3 predicts LVO with sensitivity 81% and specificity 89%. Used to guide activation of comprehensive stroke centres with thrombectomy capability. Developed by Llanes et al. 2004.

Observational pain scale for non-verbal patients with advanced dementia. Assesses 5 behavioural indicators of pain: breathing, negative vocalisations, facial expression, body language, and consolability. Score 0-10; higher score indicates more pain. Validated by Warden et al. 2003. NICE CG103 and BSG recommend structured pain assessment tools in patients who cannot self-report.

Totalled Health Risks In Vascular Events (THRIVE) score. Predicts 90-day mortality and functional outcome in ischaemic stroke patients, particularly those treated with tPA thrombolysis or mechanical thrombectomy. Based on NIHSS, age, and comorbidities (hypertension, diabetes mellitus, atrial fibrillation). Score 0-9; higher score = worse outcome. Validated by Flint et al. 2010 in SITS-MOST and NINDS datasets.

Preadmission comorbidities, Level of consciousness, Age, and Neurological deficit (PLAN) score. Predicts in-hospital complications, discharge destination, and 30-day mortality in acute ischaemic and haemorrhagic stroke patients. Score 0-25. Higher score = worse outcome. Validated by O'Donnell et al. 2012 in 1,081 stroke patients. Useful for resource allocation and ICU admission decisions.

Predicts which adult head injury patients require CT imaging. Validated Dutch decision rule with high sensitivity (100%) for intracranial traumatic findings.

Prehospital and emergency stroke severity scale to identify large vessel occlusion (LVO) stroke requiring thrombectomy. Validated as simple 5-item scale.

Patient-reported outcome measure assessing myasthenia gravis symptom severity across 8 functional domains. Validated tool for monitoring treatment response and disease progression.

Clinician-rated scale assessing functional independence in Parkinson's disease from 100% (completely independent) to 0% (vegetative functions only). Widely used complement to Hoehn-Yahr staging.

Diagnostic criteria for ESUS -- a subset of cryptogenic stroke characterised by non-lacunar infarct with embolic pattern, used to guide anticoagulation trials and workup.

Clinical decision rule to distinguish Lyme neuroborreliosis from aseptic meningitis in children with meningitis in Lyme-endemic areas. Avoids unnecessary lumbar puncture in low-risk patients.

Simple 5-variable score predicting in-hospital mortality after acute stroke. Calculated using admission data; validated across multiple stroke subtypes and settings.

Quantifies disability in multiple sclerosis and monitors changes over time. Scored 0–10 based on neurological examination across 8 functional systems. Guides treatment decisions and trial eligibility.

Head Impulse, Nystagmus, Test of Skew (HINTS). A bedside oculomotor examination to differentiate central (stroke) from peripheral (vestibular neuritis) cause of acute vestibular syndrome. More sensitive than early MRI.

International Mission for Prognosis and Clinical Trial design in TBI (IMPACT). Predicts 6-month outcome (death or vegetative state) in patients with moderate-severe TBI. Core, CT, and Lab models available.

Identifies patients with large vessel occlusion (LVO) stroke in the prehospital setting to guide direct transfer to stroke centres capable of mechanical thrombectomy.

Assesses pain in patients with dementia who cannot self-report. Six behavioural indicators scored 0–3 each. Useful in nursing home and palliative settings.

Functional Assessment Staging Test (FAST). Stages functional decline in Alzheimer disease from normal ageing (Stage 1) to severe dementia (Stage 7). Used in palliative care to determine hospice eligibility.

Abbreviated Mental Test Score — 10 item version (AMT-10). Quick bedside cognitive screening tool. Scores ≤7 indicate cognitive impairment. Widely used in UK emergency and acute medicine.

Migraine Disability Assessment (MIDAS) questionnaire. Quantifies headache-related disability over the past 3 months across work, household, and social activities. Guides treatment intensity.

Classifies clinical severity of subarachnoid haemorrhage (SAH) from ruptured aneurysm. Predicts surgical risk and outcome. Higher grade correlates with worse prognosis.

Measures degree of disability/dependence in daily activities following stroke or neurological disorder. The primary outcome measure in most stroke trials. Scored 0 (no symptoms) to 6 (death).

Douleur Neuropathique en 4 Questions (DN4). Distinguishes neuropathic pain from nociceptive pain. Score ≥4/10 is diagnostic of neuropathic pain component with 80% sensitivity and 92% specificity.

Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III motor examination. Assesses motor features of Parkinson disease. Scores 0 (normal) to 132 (severe). Used to titrate dopaminergic therapy.

Status Epilepticus Severity Score (STESS). Predicts in-hospital mortality and functional outcome in status epilepticus. Helps identify patients requiring ICU vs ward-level management.

Identifies red flag features of cauda equina syndrome requiring urgent MRI and surgical referral.

Classifies completeness of spinal cord injury (SCI) using the American Spinal Injury Association (ASIA) Impairment Scale (AIS).

Calculates cerebral perfusion pressure from mean arterial pressure and intracranial pressure. Target CPP 60-70 mmHg in TBI.

Estimates risk of conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) based on MRI and clinical features.

Abbreviated 6-item version of the NIHSS for rapid stroke severity assessment. Correlates well with full NIHSS for triage and thrombolysis decisions.

Differentiates benign paroxysmal events (migraine with aura, syncope) from epileptic seizures based on clinical features.

Cerebral Performance Category (CPC) scale for neurological outcome classification after cardiac arrest. Used in post-resuscitation care and research.

Carer-rated ADL scale for dementia patients assessing 20 daily activities. Score 0-60; higher scores indicate greater dependency. Used in acetylcholinesterase inhibitor monitoring.

Assesses functional decline in ALS/MND across 12 domains. Serial scores track progression rate and guide intervention timing (PEG, NIV).

Multicentre Epilepsy and Single Seizures (MESS) study score. Predicts risk of seizure recurrence after a first unprovoked seizure and guides early AED initiation.

Predicts probability of independent ambulation at 6 months in Guillain-Barre syndrome. Guides ICU admission and rehabilitation planning.

Quantifies neurological disability in MS patients on a 0-10 scale. Used to monitor disease progression and guide disease-modifying therapy decisions.

Screens for symptomatic diabetic peripheral neuropathy using four symptom questions. DNS >=1 has high sensitivity for confirmed DPN.

Applies modified Dandy criteria for diagnosis of IIH (pseudotumour cerebri). Guides LP, acetazolamide initiation, and bariatric/surgical intervention.

Assesses probability of autoimmune vs infectious encephalitis and guides urgent immunotherapy vs antiviral decisions. Based on European Encephalitis Consortium criteria.