🧠 ROSIER Scale (Stroke Recognition)
UseRapidly recognise acute stroke at first contact.
StrataScore > 0 makes acute stroke likely and should activate the stroke pathway; ≤ 0 does not fully exclude stroke.
LimitsDesigned as a recognition aid for non-specialists — imaging still dec… · Seizure and syncope items reduce false positives but can mask stroke-… · Always integrate time of onset and contraindication screening for rep…
SourceNor AM, et al. Lancet Neurol 2005
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Adults with suspected acute stroke when quantifying deficit and deciding reperfusion, or TIA when judging short-term risk.
- Who it is not for
- Do not use ABCD² to decide thrombolysis. No new stroke scale.
- Formula and variables
- NIHSS is the neurologic deficit; items stay as on this page. FAST-ED is a prehospital large-vessel screen. ABCD² is age, blood pressure, clinical features, duration, and diabetes, for TIA.
- Result → next step
- This scene links only to the three tools below: deficit and time window open the thrombolysis page. A positive large-vessel screen opens thrombectomy. Drugs after the acute phase open secondary prevention. Thrombolysis shows no number until weight, onset time, pregnancy, and recent anticoagulation are known. Anticoagulant-related intracranial bleeding goes to reversal and ICH management.No numeric dose until age, weight, renal function, and pregnancy are all known. Pregnancy is contraindication or caution only.IV thrombolysis →
- Guideline
- China acute ischemic stroke guideline 2023
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
Score > 0 — stroke is likely; activate the pathway.
When to use
Rapidly recognise acute stroke at first contact.
How it works
Add face/arm/leg weakness, speech disturbance, visual field defect (+1 each); subtract for loss of consciousness/syncope and seizure (−1 each). Score > 0 makes stroke likely.
Key points
- Score > 0 — stroke is likely; activate the pathway.
- ≤ 0 does not fully exclude stroke — clinical judgement applies.
- Designed for ED use by non-specialists.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Loss of consciousness/syncope | No |
|---|---|
| Seizure activity | No |
| Asymmetric facial weakness | No |
| Asymmetric arm weakness | No |
| Asymmetric leg weakness | No |
| Speech disturbance | No |
| Visual field defect | No |
→ROSIER0
- Interpretation：Score ≤ 0 — stroke less likely (does not exclude); reassess.
| Loss of consciousness/syncope | Yes (−1) |
|---|---|
| Seizure activity | Yes (−1) |
| Asymmetric facial weakness | Yes (+1) |
| Asymmetric arm weakness | Yes (+1) |
| Asymmetric leg weakness | Yes (+1) |
| Speech disturbance | Yes (+1) |
| Visual field defect | Yes (+1) |
→ROSIER+3
- Interpretation：Score > 0 — stroke likely; activate stroke pathway.
Verification & sources · governance
FAQ
Frequently asked questions
- Does ROSIER Scale (Stroke Recognition) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is ROSIER Scale (Stroke Recognition) calculated in practice? Can you show a worked example?
- Inputs: Loss of consciousness/syncope No, Seizure activity No, Asymmetric facial weakness No, Asymmetric arm weakness No, Asymmetric leg weakness No, Speech disturbance No, Visual field defect No → Result: ROSIER 0（Interpretation: Score ≤ 0 — stroke less likely (does not exclude); reassess.） Inputs: Loss of consciousness/syncope Yes (−1), Seizure activity Yes (−1), Asymmetric facial weakness Yes (+1), Asymmetric arm weakness Yes (+1), Asymmetric leg weakness Yes (+1), Speech disturbance Yes (+1), Visual field defect Yes (+1) → Result: ROSIER +3（Interpretation: Score > 0 — stroke likely; activate stroke pathway.）