The task force recommends that clinicians support their rating decisions with standardized assessment instruments whenever possible. The first area of assessment in the AHA.SOC score is the evaluation of neurological impairment. A complete clinical examination is the basis for documenting the major domains of neurological impairment. In this classification schema the number of affected domains is recorded as well as severity of impairments. Motor impairments are the most prevalent of all deficits seen after stroke, usually with involvement of the face, arm, and leg, alone or in various combinations.
Sensory deficits range from loss of primary sensations to more complex loss of perception.
Patients may describe numbness, tingling, or altered sensitivity. The more complex sensory losses include astereognosis, agraphia, and extinction to double simultaneous stimuli. Stroke can cause monocular visual loss, homonymous hemianopia, or cortical blindness. Dysphasia may be exhibited by disturbances in comprehension, naming, repetition, fluency, reading, or writing. Stroke can cause impairments in memory, attention, orientation, calculation abilities, and construction.